Provider First Line Business Practice Location Address:
65-1298B KAWAIHAE RD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAMUELA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96743-7342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-731-5003
Provider Business Practice Location Address Fax Number:
808-731-4330
Provider Enumeration Date:
07/01/2021