Provider First Line Business Practice Location Address:
1130 SCOTT BLVD
Provider Second Line Business Practice Location Address:
STE 1
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-354-2429
Provider Business Practice Location Address Fax Number:
319-354-6100
Provider Enumeration Date:
05/17/2006