Provider First Line Business Practice Location Address:
39 ALA MALAMA ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAUNAKAKAI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96748-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-553-5353
Provider Business Practice Location Address Fax Number:
808-553-4269
Provider Enumeration Date:
08/29/2012