Provider First Line Business Practice Location Address:
92-1982 KULIHI ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-3414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-295-5319
Provider Business Practice Location Address Fax Number:
888-375-8883
Provider Enumeration Date:
04/09/2007