Individual
JENNIFER N BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-5212
Mailing address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-5212
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000670
CT
Other
Enumeration date
06/03/2009
Last updated
01/07/2025
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