Provider First Line Business Practice Location Address:
94-235 HANAWAI CIR STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-3029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-677-5944
Provider Business Practice Location Address Fax Number:
808-677-3711
Provider Enumeration Date:
01/08/2007