Provider First Line Business Practice Location Address:
1421 E COLLEGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52245-4410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-338-3023
Provider Business Practice Location Address Fax Number:
319-338-2284
Provider Enumeration Date:
10/16/2006