Provider First Line Business Practice Location Address:
670 PONAHAWAI ST
Provider Second Line Business Practice Location Address:
STE 216 HILO FAMILY MEDICINE
Provider Business Practice Location Address City Name:
HILO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96720-2660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-934-8989
Provider Business Practice Location Address Fax Number:
808-934-8990
Provider Enumeration Date:
12/14/2006