Provider First Line Business Practice Location Address:
920 SOUTH OAK ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IOWA FALLS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50126-9506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-648-4631
Provider Business Practice Location Address Fax Number:
641-648-7141
Provider Enumeration Date:
09/20/2006