Individual
KIRBY L SCULLION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4004 TUSCARAWAS ST W, CANTON, OH 44708-5503
(330) 479-9750
(330) 479-9752
Mailing address
2379 17TH ST SE, EAST CANTON, OH 44730-9542
(330) 452-1597
(330) 479-9752
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3495/T1636
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442239
—
OH
Enumeration date
08/04/2006
Last updated
07/20/2013
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