Provider First Line Business Practice Location Address:
1705 S 1ST AVE
Provider Second Line Business Practice Location Address:
SUITE I
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-6006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-354-2983
Provider Business Practice Location Address Fax Number:
319-354-3221
Provider Enumeration Date:
01/04/2007