Provider First Line Business Practice Location Address:
66-590 KAMEHAMEHA HWY STE 2F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALEIWA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96712-1484
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-260-7210
Provider Business Practice Location Address Fax Number:
808-564-0050
Provider Enumeration Date:
02/27/2019