Organization
INFINITE WELL LLC
Active
Organization
INFINITE WELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOAZ ITSHAKY (OWNER)
(203) 537-0699
Entity
Organization
Contact information
Practice address
286 BEACON RD, BETHANY, CT 06524-3080
(203) 537-0699
Mailing address
286 BEACON RD, BETHANY, CT 06524-3080
(203) 537-0699
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
000258
CT
Other
Enumeration date
05/17/2016
Last updated
05/17/2016
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