Provider First Line Business Practice Location Address:
31 KAMEHAMEHA 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:
96732-2263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-877-0066
Provider Business Practice Location Address Fax Number:
808-873-0511
Provider Enumeration Date:
12/27/2005