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General NPI Number Information
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NPI Number | 1588357040
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Entity Type | Organization
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Legal Business Name | INNATE AND INTUITIVE INTEGRATION LLC
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 1000 FARMINGTON AVE STE 109
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2185
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Country | US
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Telephone | 860-222-2630
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 FARMINGTON AVE STE 109
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2185
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | TIMOTHY ARENA
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Credential |
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Telephone | 781-572-6443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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