Provider First Line Business Practice Location Address:
56-490 KAMEHAMEHA HWY R-BUILDING RM 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAHUKU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-454-7447
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/30/2012