Provider First Line Business Practice Location Address:
47388 HUI IWA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-239-6711
Provider Business Practice Location Address Fax Number:
808-239-6706
Provider Enumeration Date:
01/30/2007