Provider First Line Business Practice Location Address:
189 W 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:
96732-1606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-877-7651
Provider Business Practice Location Address Fax Number:
808-871-2171
Provider Enumeration Date:
05/22/2007