Provider First Line Business Practice Location Address:
98 1247 KAAHUMANU STREET
Provider Second Line Business Practice Location Address:
SUITE 320
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-5311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-487-7077
Provider Business Practice Location Address Fax Number:
808-487-2398
Provider Enumeration Date:
08/30/2007