Individual
ELIZA LUNDSTROM HALLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
102 SHORE DR, SUITE 104, WORCESTER, MA 01605-3154
(508) 853-7500
(508) 853-7505
Mailing address
102 SHORE DR, SUITE 104, WORCESTER, MA 01605-3154
(508) 853-7500
(508) 853-7505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13305
MA
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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