Provider First Line Business Practice Location Address:
79-1019 HAUKAPILA STREET
Provider Second Line Business Practice Location Address:
OHANA COTTAGE
Provider Business Practice Location Address City Name:
KEALAKEKUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96750-7920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-322-6990
Provider Business Practice Location Address Fax Number:
808-322-6991
Provider Enumeration Date:
01/19/2011