Provider First Line Business Practice Location Address:
2851 E MANOA RD
Provider Second Line Business Practice Location Address:
SUITE 1-203
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96822-1858
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-988-6168
Provider Business Practice Location Address Fax Number:
808-955-8155
Provider Enumeration Date:
06/11/2007