Provider First Line Business Practice Location Address:
QEII HSC 7TH FLOOR, MACKENZIE BLDG
Provider Second Line Business Practice Location Address:
5788 UNIVERSITY AVENUE
Provider Business Practice Location Address City Name:
HALIFAX
Provider Business Practice Location Address State Name:
NS
Provider Business Practice Location Address Postal Code:
B3H1V8
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
902-473-7665
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2006