Provider First Line Business Practice Location Address:
64-1035 MAMALAHOA HWY STE K
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:
96743-8440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-883-9785
Provider Business Practice Location Address Fax Number:
808-883-9683
Provider Enumeration Date:
01/24/2018