Provider First Line Business Practice Location Address:
1180 WAIANUENUE AVE
Provider Second Line Business Practice Location Address:
HAWAII STATE VETERANS HOSPITAL
Provider Business Practice Location Address City Name:
HILO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-974-4500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2007