Provider First Line Business Practice Location Address:
47 388 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:
808-239-3204
Provider Business Practice Location Address Fax Number:
808-239-3206
Provider Enumeration Date:
09/22/2006