Provider First Line Business Practice Location Address:
275 W. KAAHUMANU AVE
Provider Second Line Business Practice Location Address:
#1C01
Provider Business Practice Location Address City Name:
KAHULUI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-856-3070
Provider Business Practice Location Address Fax Number:
808-442-9635
Provider Enumeration Date:
04/25/2012