Provider First Line Business Practice Location Address:
CKHA, 80 GRAND AVENUE WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHATHAM
Provider Business Practice Location Address State Name:
ONTARIO
Provider Business Practice Location Address Postal Code:
N7L 1B7
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
519-351-6144
Provider Business Practice Location Address Fax Number:
519-351-0450
Provider Enumeration Date:
02/17/2010