Provider First Line Business Practice Location Address:
66-125 KAMEHAMEHA HWY
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:
96712-1420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-637-5111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2007