Provider First Line Business Practice Location Address:
77-137 KALANIUKA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLUALOA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96725-9729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-322-2600
Provider Business Practice Location Address Fax Number:
808-322-2071
Provider Enumeration Date:
12/12/2006