Provider First Line Business Practice Location Address:
86-3005 LEIHUA PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIANAE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96792-2953
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-695-7038
Provider Business Practice Location Address Fax Number:
808-695-7039
Provider Enumeration Date:
04/17/2007