Provider First Line Business Practice Location Address:
79-7422 MAMALAHOA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEALAKEKUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96750-7913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-329-7744
Provider Business Practice Location Address Fax Number:
808-327-0424
Provider Enumeration Date:
11/01/2006