Provider First Line Business Practice Location Address: 
VAMC
    Provider Second Line Business Practice Location Address: 
601 HWY 6
    Provider Business Practice Location Address City Name: 
IOWA CITY
    Provider Business Practice Location Address State Name: 
IA
    Provider Business Practice Location Address Postal Code: 
52246
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
319-338-0581
    Provider Business Practice Location Address Fax Number: 
319-887-4909
    Provider Enumeration Date: 
10/03/2006