Provider First Line Business Practice Location Address:
98-1238 KAAHUMANU ST STE 404A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARL CITY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96782-3292
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-488-1990
Provider Business Practice Location Address Fax Number:
808-486-8495
Provider Enumeration Date:
06/18/2008