Provider First Line Business Practice Location Address:
28 KAMOI STREET
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
KAUNAKAKAI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96748-0558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-553-5790
Provider Business Practice Location Address Fax Number:
808-553-5308
Provider Enumeration Date:
04/27/2007