Healthcare Provider Details

I. General information

NPI: 1093932329
Provider Name (Legal Business Name): INTEGRATED MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 WESTPORT AVE
NORWALK CT
06851-4344
US

IV. Provider business mailing address

365 WESTPORT AVE
NORWALK CT
06851-4344
US

V. Phone/Fax

Practice location:
  • Phone: 203-845-0400
  • Fax:
Mailing address:
  • Phone: 203-845-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number001586
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number031959
License Number StateCT

VIII. Authorized Official

Name: JOANNE SAUTER
Title or Position: MANAGER
Credential:
Phone: 203-845-0400