Provider First Line Business Practice Location Address:
665 KAHULUI BEACH ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAILUKU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96793-9679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-243-9312
Provider Business Practice Location Address Fax Number:
808-243-9320
Provider Enumeration Date:
01/30/2024