J. ANDREW HALLBERG, MD, LLC
Medical Practice at Whitehall Ave, Mystic, CT

License number
Connecticut 029044
Category
Medical Practice
Type
Specialist
Owner
Name: DR. JOHN A HALLBERG M.D.
Title: OWNER
Phone: (860) 536-0773
Address
Address
56 Whitehall Ave SUITE A, Mystic, CT 06355
National Provider ID: 1487770228
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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J. ANDREW HALLBERG, M.D. LLC

Mystic, CT

Status:
Inactive
Registration:
Apr 28, 2000
Addresses:
56 Whitehall Ave #A, Mystic, CT 06355 (Physical)
100 Stanton Ln, Mystic, CT 06355 (Mailing)
State ID:
0650305
Business type:
Domestic Limited Liability Company
PRESIDENT:
John Andrew Hallberg, M.d (PRESIDENT), 491 Goldstar Hwy, Groton, CT 06340 (Mailing)
100 Stanton Ln, Mystic, CT 06355 (Physical)
Agent:
J. Andrew Hallberg, M.d,4910 Gold Star Hwy, Groton, CT 06340 (Mailing)
100 Stanton Ln, Mystic, CT 06355 (Physical)

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