Individual
DR. MATTHEW KORY SCULLAWL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
213 W OLIVE ST, STE 101, SPRINGFIELD, MO 65806-1301
(417) 862-3937
(417) 862-3936
Mailing address
213 W OLIVE ST, STE 101, SPRINGFIELD, MO 65806-1301
(417) 862-3937
(417) 862-3936
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2006036228
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200066910A
—
OK
Enumeration date
06/26/2006
Last updated
03/17/2017
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