Provider First Line Business Practice Location Address:
3136 AKAHI ST STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIHUE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96766-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-245-2852
Provider Business Practice Location Address Fax Number:
808-245-4558
Provider Enumeration Date:
02/23/2010