Provider First Line Business Practice Location Address:
27-641 KAIEIE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAPAIKOU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96781-7717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-936-0949
Provider Business Practice Location Address Fax Number:
808-657-4450
Provider Enumeration Date:
08/12/2006