Provider First Line Business Practice Location Address:
513 S MUCKEY ST
Provider Second Line Business Practice Location Address:
BURGESS FAMILY CLINICS
Provider Business Practice Location Address City Name:
MAPLETON
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51034-1055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-882-2234
Provider Business Practice Location Address Fax Number:
712-822-2605
Provider Enumeration Date:
03/24/2010