Provider First Line Business Practice Location Address:
95-6040 MAMALAHOA HIGHWAY
Provider Second Line Business Practice Location Address:
#11-14
Provider Business Practice Location Address City Name:
NAALEHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96772-0673
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-939-8100
Provider Business Practice Location Address Fax Number:
808-829-3672
Provider Enumeration Date:
07/25/2007