Provider First Line Business Practice Location Address:
115 S GRAND AVE
Provider Second Line Business Practice Location Address:
S 521 PHARMACY BUILDING
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52242-1112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-335-8875
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2006