Provider First Line Business Practice Location Address:
81-948 WAENA 'OIHANA LOOP, SUITE 120
Provider Second Line Business Practice Location Address:
CKC BUILDING 9
Provider Business Practice Location Address City Name:
KEALAKEKUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-322-6692
Provider Business Practice Location Address Fax Number:
808-322-6693
Provider Enumeration Date:
07/12/2006