Provider First Line Business Practice Location Address:
98-1258 KAAHUMANU ST STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARL CITY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96782-3251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-487-2273
Provider Business Practice Location Address Fax Number:
808-488-3464
Provider Enumeration Date:
10/18/2006