Provider First Line Business Practice Location Address:
4-885 KUHIO HWY # A-1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPAA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96746-2702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-937-0512
Provider Business Practice Location Address Fax Number:
808-822-5454
Provider Enumeration Date:
09/30/2008