| Doctor Name: | JACOB MAGNAN |
| NPI Number: | 1366813685 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RD |
| License Number: | 074.0115928 |
| Business Practice Address: | 762 Bean Rd Apartment 2 Colchester, VT - 054466830 |
| Business Phone Number: | 4842411189 |
| Business Fax Number: | |
| Mailing Address: | 762 Bean Rd, Apartment 2 COLCHESTER |
| State: | VT |
| Postal Code: | 054466830 |
| Phone Number: | 4842411189 |
| Fax Number: | |
| NPI Enumeration Date: | 10/13/2015 |
| NPI Last Update Date: | 10/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 074.0115928 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |