Provider First Line Business Practice Location Address:
94-1133 HALEKUKUI ST UNIT 39
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-6245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-753-1550
Provider Business Practice Location Address Fax Number:
808-229-1424
Provider Enumeration Date:
03/12/2025