Provider First Line Business Practice Location Address:
228 OHUA AVE APT B
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:
96815-3672
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-333-6189
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2020