Provider First Line Business Practice Location Address:
1001 KAMOKILA BLVD
Provider Second Line Business Practice Location Address:
SUITE 114
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-674-2727
Provider Business Practice Location Address Fax Number:
808-674-2500
Provider Enumeration Date:
05/24/2006