Provider First Line Business Practice Location Address:
98-027 HEKAHA ST
Provider Second Line Business Practice Location Address:
BLDG #3 SUITE #21
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-4910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-488-2221
Provider Business Practice Location Address Fax Number:
808-488-2221
Provider Enumeration Date:
10/07/2009