Provider First Line Business Practice Location Address:
66-197 KAMEHAMEHA HWY #1
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:
96712-1400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-637-9393
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2010