Provider First Line Business Practice Location Address:
724 KAKALA ST UNIT 1401
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-4632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-353-8433
Provider Business Practice Location Address Fax Number:
808-638-3374
Provider Enumeration Date:
12/20/2005