Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Apr 7, 2020
License(s)
036173318 (IL), R-12188 (IA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 200 HAWKINS DR | Iowa City, IA 52242-1009 | 319-356-1956 |
| MAILING | 200 HAWKINS DR | Iowa City, IA 52242-1009 | 319-356-1956 |
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