Provider First Line Business Practice Location Address:
79-7266 MAMALAHOA HWY
Provider Second Line Business Practice Location Address:
SUITE 3 HONALO BUSINESS CENTER
Provider Business Practice Location Address City Name:
KEALAKEKUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-322-9400
Provider Business Practice Location Address Fax Number:
808-324-7522
Provider Enumeration Date:
10/12/2006