Provider First Line Business Practice Location Address:
98-707 IHO PLACE BLDG. 2, APT. 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-497-7660
Provider Business Practice Location Address Fax Number:
808-426-1322
Provider Enumeration Date:
01/12/2011