Organization
INTERRA SW DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE KHOURI MD (SOLE MEMBER)
(803) 917-8378
Entity
Organization
Contact information
Practice address
1 MEMORIAL RD, WEST HARTFORD, CT 06107-2208
(864) 315-2627
Mailing address
1 MEMORIAL RD, WEST HARTFORD, CT 06107-2208
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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