Provider First Line Business Practice Location Address:
4800D KAWAIHAU RD.
Provider Second Line Business Practice Location Address:
HO' OLA LAHU'I HAWAII
Provider Business Practice Location Address City Name:
KAPAA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-240-0122
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2008