Provider First Line Business Practice Location Address:
3800 KAMEHAMEHA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCEVILLE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96722-5326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-333-4263
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2022