Provider First Line Business Practice Location Address:
59-794 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
#A1
Provider Business Practice Location Address City Name:
HALEIWA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96712-9424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-224-5860
Provider Business Practice Location Address Fax Number:
808-356-1719
Provider Enumeration Date:
07/07/2014