Provider First Line Business Practice Location Address:
30 AULIKE STREET SUITE #405
Provider Second Line Business Practice Location Address:
KAILUA PROFESSIONAL CENTER 1
Provider Business Practice Location Address City Name:
KAILUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-263-7340
Provider Business Practice Location Address Fax Number:
808-263-7339
Provider Enumeration Date:
02/07/2015