Provider First Line Business Practice Location Address:
94-239 WAIPAHU DEPOT ST STE 201A
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:
96797-3072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-678-9688
Provider Business Practice Location Address Fax Number:
808-677-5958
Provider Enumeration Date:
02/21/2020