Provider First Line Business Practice Location Address:
BOX 369
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOPE
Provider Business Practice Location Address State Name:
B.C.
Provider Business Practice Location Address Postal Code:
V0X 1L0
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
604-869-5071
Provider Business Practice Location Address Fax Number:
604-869-2105
Provider Enumeration Date:
05/22/2007