Provider First Line Business Practice Location Address:
4-484 KUHIO HWY STE 106
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPAA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96746-1470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-245-2471
Provider Business Practice Location Address Fax Number:
808-213-7296
Provider Enumeration Date:
10/02/2006