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Individual

JEFF THOMAS BACKLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CCC-SLP MA

Contact information

Practice address
4725 MERLE HAY RD, DES MOINES, IA 50322-1983
(515) 331-3190
Mailing address
313 N 13TH ST, INDIANOLA, IA 50125-1617

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
002005
IA

Other

Enumeration date
08/29/2012
Last updated
08/29/2012
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