Provider First Line Business Practice Location Address:
65-1230 MAMALAHOA HWY A21
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAMUELA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96743-7317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-885-8465
Provider Business Practice Location Address Fax Number:
808-885-8470
Provider Enumeration Date:
02/09/2007