Provider First Line Business Practice Location Address:
210 RIDGE
Provider Second Line Business Practice Location Address:
JENNIE EDMUNDSEN HOSPITAL
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-393-6700
Provider Business Practice Location Address Fax Number:
402-393-1098
Provider Enumeration Date:
03/24/2009