Provider First Line Business Practice Location Address:
22 ONEAWA ST.
Provider Second Line Business Practice Location Address:
#D
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:
808-347-5243
Provider Business Practice Location Address Fax Number:
808-888-7891
Provider Enumeration Date:
03/25/2010