Provider First Line Business Practice Location Address:
95 390 KUAHELANI AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILILANI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96789
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-627-3200
Provider Business Practice Location Address Fax Number:
808-623-8782
Provider Enumeration Date:
01/27/2006