Provider First Line Business Practice Location Address:
54-237 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAUULA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96717-9522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-655-4115
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2007