Provider First Line Business Practice Location Address:
3-3359 KUHIO HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIHUE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96766-1061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-378-4869
Provider Business Practice Location Address Fax Number:
808-320-3329
Provider Enumeration Date:
09/23/2016