Provider First Line Business Practice Location Address:
81-1043 KONAWAENA SCHOOL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEALAKEKUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96750-8121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-323-4500
Provider Business Practice Location Address Fax Number:
808-323-4515
Provider Enumeration Date:
02/22/2007