Provider First Line Business Practice Location Address:
803 KAMEHAMEHA HWY STE 309
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARL CITY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96782-2638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-456-5553
Provider Business Practice Location Address Fax Number:
808-455-6520
Provider Enumeration Date:
01/22/2007