Provider First Line Business Practice Location Address: 
875 WAIMANU ST
    Provider Second Line Business Practice Location Address: 
SUITE 600
    Provider Business Practice Location Address City Name: 
HONOLULU
    Provider Business Practice Location Address State Name: 
HI
    Provider Business Practice Location Address Postal Code: 
96813-5248
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
808-537-2273
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
07/10/2014