Provider First Line Business Practice Location Address:
64-1510 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAHIAWA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96786-2915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-622-3929
Provider Business Practice Location Address Fax Number:
808-621-8227
Provider Enumeration Date:
02/29/2008