Provider First Line Business Practice Location Address:
220 IMI KALA ST
Provider Second Line Business Practice Location Address:
UNIT 102
Provider Business Practice Location Address City Name:
WAILUKU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-242-6605
Provider Business Practice Location Address Fax Number:
808-242-5819
Provider Enumeration Date:
04/30/2008