Provider First Line Business Practice Location Address:
1142 KOKO HEAD AVE
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:
96816-3710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-735-7773
Provider Business Practice Location Address Fax Number:
808-735-7773
Provider Enumeration Date:
06/01/2006