Provider First Line Business Practice Location Address:
1114 N DODGE 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:
52245-6121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-390-2137
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2022