Provider First Line Business Practice Location Address:
700 WAIALE RD
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:
96793-2475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-872-9742
Provider Business Practice Location Address Fax Number:
808-873-9370
Provider Enumeration Date:
12/23/2013