Provider First Line Business Practice Location Address:
803 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
STE. 416
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-488-5647
Provider Business Practice Location Address Fax Number:
808-486-3416
Provider Enumeration Date:
11/27/2006