Provider First Line Business Practice Location Address:
720 S DUBUQUE ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-4249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-354-8057
Provider Business Practice Location Address Fax Number:
319-354-3623
Provider Enumeration Date:
05/01/2007