Provider First Line Business Practice Location Address:
201 S. CLINTON
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-338-7952
Provider Business Practice Location Address Fax Number:
319-338-6931
Provider Enumeration Date:
11/10/2005