Provider First Line Business Practice Location Address:
98-1238 KA'AHUMANU ST
Provider Second Line Business Practice Location Address:
#305
Provider Business Practice Location Address City Name:
PEARL CITY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-487-3355
Provider Business Practice Location Address Fax Number:
808-486-3535
Provider Enumeration Date:
09/26/2006