Provider First Line Business Practice Location Address:
1670 MAKALOA ST STE 201
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:
96814-3232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-979-6930
Provider Business Practice Location Address Fax Number:
808-447-7736
Provider Enumeration Date:
12/27/2013