Provider First Line Business Practice Location Address:
46001 KAMEHAMEHA HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744-3728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-235-2121
Provider Business Practice Location Address Fax Number:
808-247-8475
Provider Enumeration Date:
08/14/2006