Provider First Line Business Practice Location Address:
92-7075 ELELE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-295-8568
Provider Business Practice Location Address Fax Number:
808-672-3605
Provider Enumeration Date:
11/13/2008