Provider First Line Business Practice Location Address:
880 KAMEHAMEHA HWY
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:
96782-2649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-456-5888
Provider Business Practice Location Address Fax Number:
808-455-6936
Provider Enumeration Date:
11/22/2006