Provider First Line Business Practice Location Address:
98-1277 KAAHUMANU ST
Provider Second Line Business Practice Location Address:
STE 106, PMB 700
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-5314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-479-2146
Provider Business Practice Location Address Fax Number:
808-237-3698
Provider Enumeration Date:
03/08/2013