Provider First Line Business Practice Location Address:
94-849 LUMIAINA ST
Provider Second Line Business Practice Location Address:
WAIKELE PROFESSIONAL CTR, SUITE 207
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-5025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-677-8222
Provider Business Practice Location Address Fax Number:
808-677-8333
Provider Enumeration Date:
11/22/2005