Individual
MATTHEW PHILIP SCULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(616) 717-0169
Mailing address
4061 CLOUD PARK DR, APRT B-2, HUBER HEIGHTS, OH 45424-8084
(616) 717-0169
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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