Provider First Line Business Practice Location Address:
118 1/2 S DUBUQUE ST
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:
52240-4006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-301-0648
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2013