Provider First Line Business Practice Location Address:
2033 NUUANU AVE APT 27B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-2532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-735-9093
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2006