Provider First Line Business Practice Location Address:
66125 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALEIWA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-637-5087
Provider Business Practice Location Address Fax Number:
808-637-4765
Provider Enumeration Date:
05/27/2009