Provider First Line Business Practice Location Address:
94-748 B. HIKIMOE ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-671-7155
Provider Business Practice Location Address Fax Number:
808-671-7155
Provider Enumeration Date:
06/19/2013