Provider First Line Business Practice Location Address:
2120 KAOHU STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAILUKU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-242-1199
Provider Business Practice Location Address Fax Number:
808-424-4411
Provider Enumeration Date:
01/22/2007