Provider First Line Business Practice Location Address:
950 KAMEHAMEHA HWY UNIT 962
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:
96782-5042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-494-1528
Provider Business Practice Location Address Fax Number:
808-210-6095
Provider Enumeration Date:
12/13/2023