Provider First Line Business Practice Location Address:
4211 WAIALAE AVE
Provider Second Line Business Practice Location Address:
SUITE 206A
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-5306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-284-4497
Provider Business Practice Location Address Fax Number:
808-735-2495
Provider Enumeration Date:
09/02/2006