Provider First Line Business Practice Location Address:
103 E COLLEGE STREET
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-4008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-351-8281
Provider Business Practice Location Address Fax Number:
319-466-9030
Provider Enumeration Date:
11/06/2006