Provider First Line Business Practice Location Address: 
1450 ALA MOANA BLVD STE 1300
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
HONOLULU
    Provider Business Practice Location Address State Name: 
HI
    Provider Business Practice Location Address Postal Code: 
96814-4624
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
808-492-5066
    Provider Business Practice Location Address Fax Number: 
808-425-4706
    Provider Enumeration Date: 
05/01/2020