Provider First Line Business Practice Location Address:
32 KAINEHE ST
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
KAILUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96734-2641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-262-7463
Provider Business Practice Location Address Fax Number:
808-489-7815
Provider Enumeration Date:
03/26/2007