Provider First Line Business Practice Location Address:
2229 KULA KOLEA DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-799-3402
Provider Business Practice Location Address Fax Number:
808-842-1421
Provider Enumeration Date:
07/12/2019