Provider First Line Business Practice Location Address:
3600 30TH STREET
Provider Second Line Business Practice Location Address:
VA CENTRAL IOWA HEALTH SYSTEM
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-699-5999
Provider Business Practice Location Address Fax Number:
515-699-5924
Provider Enumeration Date:
07/27/2006