Provider First Line Business Practice Location Address:
4747 KILAUEA AVE
Provider Second Line Business Practice Location Address:
#201
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-5308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-542-4029
Provider Business Practice Location Address Fax Number:
808-739-2828
Provider Enumeration Date:
01/21/2007