Provider First Line Business Practice Location Address:
1825 LOGAN AVE RM 551
Provider Second Line Business Practice Location Address:
ALLEN HOSPITAL ANTICOAGULATION CLINIC
Provider Business Practice Location Address City Name:
WATERLOO
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50703-1916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-235-3172
Provider Business Practice Location Address Fax Number:
319-235-3408
Provider Enumeration Date:
05/23/2013