Provider First Line Business Practice Location Address:
4-1543 KUHIO HWY STE G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPAA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96746-1897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-822-3600
Provider Business Practice Location Address Fax Number:
808-822-3663
Provider Enumeration Date:
12/05/2013