Provider First Line Business Practice Location Address:
285 KAAHUMANU AVE
Provider Second Line Business Practice Location Address:
SUITE 205
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:
808-873-0060
Provider Business Practice Location Address Fax Number:
808-873-6510
Provider Enumeration Date:
03/07/2008