Provider First Line Business Practice Location Address:
919 LEHUA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARL CITY
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96782-3328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-453-1919
Provider Business Practice Location Address Fax Number:
808-453-1929
Provider Enumeration Date:
06/17/2006