Provider First Line Business Practice Location Address: 
615 PIIKOI ST.
    Provider Second Line Business Practice Location Address: 
# 203
    Provider Business Practice Location Address City Name: 
HONOLULU
    Provider Business Practice Location Address State Name: 
HI
    Provider Business Practice Location Address Postal Code: 
96814
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
808-589-1829
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
08/26/2009