Provider First Line Business Practice Location Address:
4819 KILAUEA AVE STE 7
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:
96816-5712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-735-4433
Provider Business Practice Location Address Fax Number:
808-735-9579
Provider Enumeration Date:
04/18/2011