Provider First Line Business Practice Location Address:
98-084 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-5122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-484-1190
Provider Business Practice Location Address Fax Number:
808-590-2216
Provider Enumeration Date:
02/15/2007