Provider First Line Business Practice Location Address:
795 EGLINTON AVENUE EAST
Provider Second Line Business Practice Location Address:
LEASIDE HEALTH CENTRE
Provider Business Practice Location Address City Name:
TORONTO
Provider Business Practice Location Address State Name:
ONTARIO
Provider Business Practice Location Address Postal Code:
M4G4E4
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
416-424-3145
Provider Business Practice Location Address Fax Number:
416-424-2611
Provider Enumeration Date:
10/17/2011