Provider First Line Business Practice Location Address:
100 HAWKINS DR
Provider Second Line Business Practice Location Address:
226 UNIVERSITY HOSPITAL SCHOOL
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-356-4107
Provider Business Practice Location Address Fax Number:
319-356-3715
Provider Enumeration Date:
05/17/2006