Provider First Line Business Practice Location Address:
39 W KAMEHAMEHA AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
KAHULUI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96732-2263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-877-2424
Provider Business Practice Location Address Fax Number:
808-877-6464
Provider Enumeration Date:
11/30/2006