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Individual

JENNIFER M BACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
683 W ORCHID LN, CHANDLER, AZ 85225-6515
(480) 341-0915
Mailing address
683 W ORCHID LN, CHANDLER, AZ 85225-6515
(480) 341-0915

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
215396
AZ

Other

Enumeration date
01/11/2021
Last updated
01/11/2021
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