Provider First Line Business Practice Location Address:
740 MOOWAA ST STE F
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:
96817-4428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-848-5197
Provider Business Practice Location Address Fax Number:
808-842-1552
Provider Enumeration Date:
12/21/2005