Provider First Line Business Practice Location Address:
540 E. JEFFERSON STREET
Provider Second Line Business Practice Location Address:
STE. 302
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-339-3611
Provider Business Practice Location Address Fax Number:
319-339-3878
Provider Enumeration Date:
05/12/2009