Provider First Line Business Practice Location Address:
98-1005 MOANALUA RD.
Provider Second Line Business Practice Location Address:
STE. 847
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-4726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-487-7933
Provider Business Practice Location Address Fax Number:
808-484-2351
Provider Enumeration Date:
03/14/2006