Provider First Line Business Practice Location Address:
70 E KAAHUMANU AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAHULUI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96732-2176
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-877-0068
Provider Business Practice Location Address Fax Number:
808-877-3607
Provider Enumeration Date:
06/13/2006