Provider First Line Business Practice Location Address:
3-3295 KUHIO HWY
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:
96766-1040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-245-8874
Provider Business Practice Location Address Fax Number:
808-246-9080
Provider Enumeration Date:
06/16/2005