Provider First Line Business Practice Location Address:
4300 WAIALAE AVE APT B1002
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:
96816-5757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-284-2200
Provider Business Practice Location Address Fax Number:
888-668-8527
Provider Enumeration Date:
09/24/2006