Provider First Line Business Practice Location Address:
933 E PIERCE ST
Provider Second Line Business Practice Location Address:
ATTN: RADIOLOGY DEPT
Provider Business Practice Location Address City Name:
COUNCIL BLUFFS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51503-4652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-396-6140
Provider Business Practice Location Address Fax Number:
712-396-6227
Provider Enumeration Date:
12/13/2022