Provider First Line Business Practice Location Address:
95-390 KUAHELANI AVE
Provider Second Line Business Practice Location Address:
STE 4B
Provider Business Practice Location Address City Name:
MILILANI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96789-1182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-623-2888
Provider Business Practice Location Address Fax Number:
808-623-2440
Provider Enumeration Date:
06/15/2006