Provider First Line Business Practice Location Address:
1596 KAWELOKA ST
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:
96782-1517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-670-8730
Provider Business Practice Location Address Fax Number:
808-425-5033
Provider Enumeration Date:
07/25/2022