Provider First Line Business Practice Location Address:
642 ULUKAHIKI ST.
Provider Second Line Business Practice Location Address:
SUITE 642
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:
808-261-6644
Provider Business Practice Location Address Fax Number:
808-261-6645
Provider Enumeration Date:
10/03/2005