Provider First Line Business Practice Location Address:
94-050 FARRINGTON HWY
Provider Second Line Business Practice Location Address:
#E1-2
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-1841
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-677-2451
Provider Business Practice Location Address Fax Number:
808-671-6220
Provider Enumeration Date:
05/22/2009