Provider First Line Business Practice Location Address:
239 E WAKEA 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:
96732-2444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-877-3984
Provider Business Practice Location Address Fax Number:
808-871-6498
Provider Enumeration Date:
11/03/2006