Provider First Line Business Practice Location Address:
47-388 HUI IWA ST STE 21B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744-4416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-233-9219
Provider Business Practice Location Address Fax Number:
808-444-3744
Provider Enumeration Date:
12/29/2022