Provider First Line Business Practice Location Address:
1131 KUALA STREET
Provider Second Line Business Practice Location Address:
C/O THE VISION CENTER
Provider Business Practice Location Address City Name:
PEARL CITY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-455-5650
Provider Business Practice Location Address Fax Number:
808-455-5625
Provider Enumeration Date:
08/25/2006