Provider First Line Business Practice Location Address:
79-7452 A MAMALAHOA HWY.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEALAKEKUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96750-2346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-936-2252
Provider Business Practice Location Address Fax Number:
808-322-0694
Provider Enumeration Date:
04/27/2007