Provider First Line Business Practice Location Address:
4-1054 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:
96746-1626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-823-7007
Provider Business Practice Location Address Fax Number:
808-823-7008
Provider Enumeration Date:
07/15/2009