Provider First Line Business Practice Location Address:
86-294 ALAMIHI ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIANAE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96792-2911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-542-4543
Provider Business Practice Location Address Fax Number:
808-626-5676
Provider Enumeration Date:
10/27/2010