Provider First Line Business Practice Location Address:
4-1558 KUHIO HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPAA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96746-1856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-821-2027
Provider Business Practice Location Address Fax Number:
808-821-2028
Provider Enumeration Date:
09/21/2007