Provider First Line Business Practice Location Address:
328 ULUNIU ST
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
KAILUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96734-2547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-292-0962
Provider Business Practice Location Address Fax Number:
808-738-5821
Provider Enumeration Date:
01/22/2007