Washington
505 Highway 1 South, Washington, IA 52353
Toll Free: (888) 665-4000

Iowa City
2901 Northgate Dr. Ste. B, Iowa City, IA 52245
Toll Free: (866) 956-0202

  • Web Site Options:
  • Printer Friendly
  • Send to a Friend
  • Add To Your Favorites
  • Re-Size Your Text: Aa Aa Aa

Secure Online Bill Pay

Patient Information
Required Fields
Patient First Name
Patient Middle Name
Patient Last Name
Address
Address Line 2
City
State
Zip
Phone Number
Email Address
Payment Information
Required Fields
Account / Invoice Number
Amount of Payment $

Card Type


Credit Card #
Expiration Date /
Month      Year
CVV #
What's this?  
Name as it Appears on Card