Provider First Line Business Practice Location Address:
43 W KAMEHAMEHA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAHULUI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96732-2256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-269-6419
Provider Business Practice Location Address Fax Number:
808-442-9015
Provider Enumeration Date:
03/22/2011