Provider First Line Business Practice Location Address:
59-712 KAMEHAMEHA HWY STE A
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:
96712-8410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-638-7883
Provider Business Practice Location Address Fax Number:
808-638-5305
Provider Enumeration Date:
10/02/2009