Provider First Line Business Practice Location Address:
3501 HARRY LANGDON BLVD STE 1450
Provider Second Line Business Practice Location Address:
CHILD HEALTH SPECIALTY CLINICS
Provider Business Practice Location Address City Name:
COUNCIL BLUFFS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51503-7837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-309-0041
Provider Business Practice Location Address Fax Number:
712-309-0044
Provider Enumeration Date:
02/06/2007