Provider First Line Business Practice Location Address:
3-3100 KUHIO HWY
Provider Second Line Business Practice Location Address:
SUITE C-13
Provider Business Practice Location Address City Name:
LIHUE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96766-1186
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-635-5223
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006