Provider First Line Business Practice Location Address:
98-1079 MOANALUA RD.
Provider Second Line Business Practice Location Address:
FIRST FLOOR, MEDICAL STAFF SERVICES, PALI MOMI MEDICAL
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-485-4109
Provider Business Practice Location Address Fax Number:
808-485-4124
Provider Enumeration Date:
03/22/2012