Provider First Line Business Practice Location Address:
3660 WAIALAE AVE
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-3257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-942-1144
Provider Business Practice Location Address Fax Number:
808-942-1142
Provider Enumeration Date:
06/24/2015