Provider First Line Business Practice Location Address:
505 E WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-1842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-354-6238
Provider Business Practice Location Address Fax Number:
319-354-6238
Provider Enumeration Date:
05/14/2007