Individual
JENNIFER L BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
512 S FREMONT ST, SHENANDOAH, IA 51601-1508
(712) 246-0092
Mailing address
512 S FREMONT ST, SHENANDOAH, IA 51601-1508
(712) 246-0092
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01746
IA
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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