Provider First Line Business Practice Location Address:
94-873 FARRINGTON HWY
Provider Second Line Business Practice Location Address:
SUITE #202
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-3150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-677-4041
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2006