Provider First Line Business Practice Location Address:
4211 WAIALAE AVE
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:
96816-5319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-732-0782
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2018