Provider First Line Business Practice Location Address:
42-470 KALANIANAOLE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAILUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96734-4373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-266-7942
Provider Business Practice Location Address Fax Number:
808-266-9933
Provider Enumeration Date:
02/24/2020