Provider First Line Business Practice Location Address:
509 N. MADISON
Provider Second Line Business Practice Location Address:
DAVIS COUNTY HOSPITAL
Provider Business Practice Location Address City Name:
BLOOMFIELD
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52537-1271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-596-0417
Provider Business Practice Location Address Fax Number:
573-596-0524
Provider Enumeration Date:
04/21/2006