Individual
THERESA A BACK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1299 OLENTANGY RIVER RD, COLUMBUS, OH 43212-3135
(614) 566-4710
(614) 566-6846
Mailing address
1299 OLENTANGY RIVER RD, STE 103, COLUMBUS, OH 43212-3135
(614) 566-4278
(614) 566-5424
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP08235
OH
Other
Enumeration date
10/31/2005
Last updated
07/08/2007
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