Individual
PROF. JOSEPH KULLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12 COACHLIGHT CIR, PROSPECT, CT 06712-1564
(203) 521-7040
Mailing address
12 COACHLIGHT CIR, PROSPECT, CT 06712-1564
(203) 521-7040
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
5867
CT
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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