Organization
INNOVA-SG CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JOHN PECK (PRESIDENT/CEO)
(617) 515-3970
Entity
Organization
Contact information
Practice address
800 VILLAGE WALK, #199, GUILFORD, CT 06437-2762
(617) 515-3970
(203) 533-5296
Mailing address
800 VILLAGE WALK, #199, GUILFORD, CT 06437-2762
(617) 515-3970
(203) 533-5296
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/10/2009
Last updated
07/10/2009
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