Provider First Line Business Practice Location Address: 
888 S KING ST
    Provider Second Line Business Practice Location Address: 
HEALTH EDUCATION CENTER (FIC 940)
    Provider Business Practice Location Address City Name: 
HONOLULU
    Provider Business Practice Location Address State Name: 
HI
    Provider Business Practice Location Address Postal Code: 
96813-3009
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
808-522-3339
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
08/10/2007