Provider First Line Business Practice Location Address:
1570 S 1ST AVE
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-6012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-358-7801
Provider Business Practice Location Address Fax Number:
319-248-1212
Provider Enumeration Date:
12/20/2006