Individual
DR. THEODORE A BUCCILLI JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4403 CLOVER DR, RAVENNA, OH 44266-8636
(330) 687-7464
Mailing address
5500 ARMSTRONG RD, BATTLE CREEK, MI 49037-7314
(269) 966-5600
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36003352
OH
Other
Enumeration date
10/31/2005
Last updated
08/15/2025
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