Provider First Line Business Practice Location Address:
200 S 4TH ST
Provider Second Line Business Practice Location Address:
EMERGENCY MEDICAL SERVICE
Provider Business Practice Location Address City Name:
COUNCIL BLUFFS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51503-6529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-328-4646
Provider Business Practice Location Address Fax Number:
712-328-4984
Provider Enumeration Date:
12/19/2005