Individual
JASON PHILLIP FARIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
HEALTH SERVICES TECH
Contact information
Practice address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100
(860) 444-8424
Mailing address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100
(860) 444-8424
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/27/2006
Last updated
07/08/2007
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