Interra SW Diagnostics LLC
NPI #1013669381 in West Hartford, Connecticut
Provider Information
- NPI Number
- 1013669381
- Entity Type
- Organization
- Organization Name
- Interra SW Diagnostics LLC
- Primary Specialty
- Psychiatry & Neurology - Neurology
- Enumeration Date
- Jan 19, 2022
- Last Updated
- Jan 19, 2022
Practice Location
- Address
- 1 MEMORIAL RD
- City
- West Hartford
- State
- Connecticut
- ZIP Code
- 06107-2208
- Phone
- (864) 315-2627
Authorized Official
- Name
- GEORGE KHOURI, MD
- Title
- SOLE MEMBER
- Phone
- (803) 917-8378
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Neurology — Neurology |
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