Provider First Line Business Practice Location Address:
110 E KAAHUMANU AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAHULUI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96732-2118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
88-711-7308
Provider Business Practice Location Address Fax Number:
808-984-7444
Provider Enumeration Date:
02/01/2011