Provider First Line Business Practice Location Address:
7192 KALANIANAOLE HWY
Provider Second Line Business Practice Location Address:
SUITE D202
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-395-3765
Provider Business Practice Location Address Fax Number:
808-441-0990
Provider Enumeration Date:
09/13/2012