Provider First Line Business Practice Location Address:
45-1144 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
SUITE 200D
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744-3244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-699-8112
Provider Business Practice Location Address Fax Number:
808-626-5376
Provider Enumeration Date:
05/24/2010