Provider First Line Business Practice Location Address:
1522 MAKALOA ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-3255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-469-1997
Provider Business Practice Location Address Fax Number:
808-941-6965
Provider Enumeration Date:
01/03/2014