Provider First Line Business Practice Location Address:
45-260 WAIKALUA RD.
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744-3516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-234-5562
Provider Business Practice Location Address Fax Number:
808-650-5031
Provider Enumeration Date:
07/18/2006