Provider First Line Business Practice Location Address:
64-5193 KINOHOU ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAMUELA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96743-8446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-885-1080
Provider Business Practice Location Address Fax Number:
808-885-1080
Provider Enumeration Date:
12/06/2007