Provider First Line Business Practice Location Address:
3624 WAOKANAKA ST
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:
96817-5298
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-595-5817
Provider Business Practice Location Address Fax Number:
808-595-8250
Provider Enumeration Date:
10/03/2016