Provider First Line Business Practice Location Address:
4-976 KUHIO HWY
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:
96746-1572
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-822-9393
Provider Business Practice Location Address Fax Number:
808-822-7993
Provider Enumeration Date:
12/09/2010