Provider First Line Business Practice Location Address:
450 - 8TH STREET
Provider Second Line Business Practice Location Address:
BOX 300
Provider Business Practice Location Address City Name:
FORT QU'APPELLE
Provider Business Practice Location Address State Name:
SASKATCHEWAN
Provider Business Practice Location Address Postal Code:
S0G 1S0
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
306-332-3620
Provider Business Practice Location Address Fax Number:
306-332-5033
Provider Enumeration Date:
12/03/2008