Provider First Line Business Practice Location Address:
53-474 HALAULA-MAULILI RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPAAU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-315-0777
Provider Business Practice Location Address Fax Number:
808-339-7455
Provider Enumeration Date:
06/14/2014