Provider First Line Business Practice Location Address:
5-4280 KUHIO HWY
Provider Second Line Business Practice Location Address:
SUITE B206
Provider Business Practice Location Address City Name:
PRINCEVILLE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96722-5438
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-826-7000
Provider Business Practice Location Address Fax Number:
808-826-7600
Provider Enumeration Date:
07/30/2006