Provider First Line Business Practice Location Address:
3-3178 KUHIO HWY STE D2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIHUE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96766-1172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-466-1863
Provider Business Practice Location Address Fax Number:
808-900-3647
Provider Enumeration Date:
10/30/2023