Provider First Line Business Practice Location Address: 
1188 BISHOP ST STE 2905
    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: 
96813-3312
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
808-372-1330
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
07/01/2019