Provider First Line Business Practice Location Address:
95-720 LANIKUHANA AVE
Provider Second Line Business Practice Location Address:
140
Provider Business Practice Location Address City Name:
MILILANI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96789-2985
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-623-6244
Provider Business Practice Location Address Fax Number:
808-623-6414
Provider Enumeration Date:
07/31/2012