Provider First Line Business Practice Location Address:
98-199 KAMEHAMEHA HWY STE F3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-4820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-364-6289
Provider Business Practice Location Address Fax Number:
808-470-6344
Provider Enumeration Date:
09/01/2020