Individual
JONATHAN J HALLENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 872-1000
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
(207) 777-1439
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
012745
ME
Other
Enumeration date
12/22/2005
Last updated
11/11/2014
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