Provider First Line Business Practice Location Address:
312 E MAIN ST
Provider Second Line Business Practice Location Address:
STE 2300, MARSHALLTOWN ANESTHESIOLOGISTS PLC
Provider Business Practice Location Address City Name:
MARSHALLTOWN
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50158-1888
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-752-7149
Provider Business Practice Location Address Fax Number:
641-752-6320
Provider Enumeration Date:
11/17/2005