Provider First Line Business Practice Location Address:
5-4280 KUHIO HWY STE G210-B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCEVILLE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96722-5451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-253-3435
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/17/2011