Provider Demographics
NPI:1023598968
Name:ARNOLD, DAVID (PT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:281-397-3370
Mailing Address - Fax:281-397-3370
Practice Address - Street 1:890 NORTH GREEN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:BROWNBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1031
Practice Address - Country:US
Practice Address - Phone:317-520-5479
Practice Address - Fax:317-939-4456
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist