Provider First Line Business Practice Location Address:
4211 WAIALAE AVE
Provider Second Line Business Practice Location Address:
STE. 206B
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-5319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-739-6224
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2006