Provider First Line Business Practice Location Address:
1607 E 33RD ST
Provider Second Line Business Practice Location Address:
ELLEFSON FREE CLINIC
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50317-2705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-266-7622
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/10/2007