Provider First Line Business Practice Location Address:
94-060 FARRINGTON HWY # 6
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:
96797-1840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-676-8116
Provider Business Practice Location Address Fax Number:
808-678-0260
Provider Enumeration Date:
06/13/2006