Provider First Line Business Practice Location Address:
3-3100 KUHIO HWY STE C15
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIHUE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96766-1153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-246-8855
Provider Business Practice Location Address Fax Number:
808-246-0415
Provider Enumeration Date:
02/05/2007