Provider First Line Business Practice Location Address:
411537 KALANIANAOLE HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE 10B
Provider Business Practice Location Address City Name:
WAIMANALO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96795
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-259-9454
Provider Business Practice Location Address Fax Number:
808-259-5714
Provider Enumeration Date:
12/12/2006