Provider First Line Business Practice Location Address:
3989 DIAMOND HEAD RD
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:
96816-4413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-737-7995
Provider Business Practice Location Address Fax Number:
808-732-9531
Provider Enumeration Date:
10/10/2006