Provider First Line Business Practice Location Address:
2240 KUHIO AVE APT 2114
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:
96815-2814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-519-2053
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2007