Provider First Line Business Practice Location Address:
95-119 KAM HWY
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MILILANI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96789-3393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-623-2212
Provider Business Practice Location Address Fax Number:
808-625-2917
Provider Enumeration Date:
06/08/2006