Provider First Line Business Practice Location Address:
4-831 KUHIO HWY.
Provider Second Line Business Practice Location Address:
SAFEWAY
Provider Business Practice Location Address City Name:
KAPAA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96746-3318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-822-2191
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2010