Provider First Line Business Practice Location Address:
92-1238 KAAHUMANU ST.
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
PEARL CITY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96782-3250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-689-8811
Provider Business Practice Location Address Fax Number:
808-689-0316
Provider Enumeration Date:
04/19/2010