Individual
LESLIE C. BAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNSD, RD, LDN
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7252
(508) 941-6412
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7252
(508) 941-6412
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
2187
MA
Other
Enumeration date
01/24/2008
Last updated
01/24/2008
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