| Interra Sw Diagnostics Llc | |
|
1 Memorial Rd West Hartford CT 06107-2208 | |
| (864) 315-2627 | |
| Not Available |
| Full Name | Interra Sw Diagnostics Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1 Memorial Rd, West Hartford, Connecticut |
| Authorized Official Name and Position | George Khouri (SOLE MEMBER) |
| Authorized Official Contact | 8039178378 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Interra Sw Diagnostics Llc 1 Memorial Rd West Hartford CT 06107-2208 Ph: () - | Interra Sw Diagnostics Llc 1 Memorial Rd West Hartford CT 06107-2208 Ph: (864) 315-2627 |
| NPI Number | 1013669381 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 01/19/2022 |
| Certification Date | 01/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013669381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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