Provider First Line Business Practice Location Address:
850 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
SUITE 155
Provider Business Practice Location Address City Name:
PEARL CITY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96782-2657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-454-2565
Provider Business Practice Location Address Fax Number:
808-454-2569
Provider Enumeration Date:
11/15/2006