Provider First Line Business Practice Location Address:
720 S DUBUQUE ST STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-4242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-214-0409
Provider Business Practice Location Address Fax Number:
319-359-4144
Provider Enumeration Date:
08/31/2009