Provider First Line Business Practice Location Address:
1201 PENN AVENUE
Provider Second Line Business Practice Location Address:
PENN AVENUE INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-471-9200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2012