Individual
KIERAN SCANLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6450 VICTORY DR, AUBURN, NY 13021-9008
(315) 283-8562
Mailing address
6450 VICTORY DR, AUBURN, NY 13021-9008
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004909-01
NY
2255A2300X
Athletic Trainer
RT008613
PA
Other
Enumeration date
06/28/2023
Last updated
09/18/2025
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