Provider First Line Business Practice Location Address:
209 EAST WASHINGTON STREET
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-3928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-354-3232
Provider Business Practice Location Address Fax Number:
319-354-2990
Provider Enumeration Date:
09/29/2006