Provider First Line Business Practice Location Address:
711 SOUTH KAMEHAMEHA AVENUE
Provider Second Line Business Practice Location Address:
APT. 3D6
Provider Business Practice Location Address City Name:
KAHULUI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-825-4610
Provider Business Practice Location Address Fax Number:
808-825-4611
Provider Enumeration Date:
08/13/2024