Provider First Line Business Practice Location Address:
1200 PLEASANT STREET
Provider Second Line Business Practice Location Address:
BLANK CHILDREN'S HOSPITAL
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-241-6611
Provider Business Practice Location Address Fax Number:
515-241-6635
Provider Enumeration Date:
03/24/2006