Provider First Line Business Practice Location Address:
3-3367 KUHIO HWY STE 200
Provider Second Line Business Practice Location Address:
KAUAI CBOC
Provider Business Practice Location Address City Name:
LIHUE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96766-1034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-246-0497
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2006