Provider First Line Business Practice Location Address:
HC-01 BOX 372 KAMEHAMEHA V HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UALAPU'E
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-558-8480
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2009