Provider First Line Business Practice Location Address:
338 KAMOKILA BLVD
Provider Second Line Business Practice Location Address:
#201
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-674-9998
Provider Business Practice Location Address Fax Number:
808-674-9877
Provider Enumeration Date:
08/29/2013