Provider First Line Business Practice Location Address:
579 FARRINGTON HWY
Provider Second Line Business Practice Location Address:
#101
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-674-8811
Provider Business Practice Location Address Fax Number:
808-674-8899
Provider Enumeration Date:
06/04/2010