Provider First Line Business Practice Location Address:
KOHANAIKI CLUB SERVICES
Provider Second Line Business Practice Location Address:
73-2055 ALA KOHANAIKI
Provider Business Practice Location Address City Name:
KAILUA-KONA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-896-7341
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2020