Individual
MR. EDWARD BRUCE KIRN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
249 MAIN STREET, LEWISTON, ME 04240-7053
(207) 783-9653
(207) 782-3153
Mailing address
249 MAIN STREET, LEWISTON, ME 04240-7053
(207) 783-9653
(207) 782-3153
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT504
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821013913
—
ME
05
—
240380099
—
ME
Enumeration date
07/12/2006
Last updated
04/03/2012
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