Provider First Line Business Practice Location Address:
1710 E WEST RD
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:
96822-2317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-956-8965
Provider Business Practice Location Address Fax Number:
808-956-5834
Provider Enumeration Date:
09/20/2006