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NPI Code Detail

MEDICARE: MRS. TRACI ARNOLD PTA

MEDICARE: MRS. TRACI ARNOLD PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant06003048AIN

General Provider Information

NPI Number : 1417286642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACI ARNOLD PTA
Provider Business Mailing Address
First Line : 6292 DUSTY LAUREL DR
Second Line :
City : WHITESTOWN
State : IN
Zip : 46075-9726
Country : US
Telephone Number : 317-769-6936
Fax Number :
Provider Business Practice Location Address
First Line : 2055 HERITAGE DR
Second Line :
City : MARTINSVILLE
State : IN
Zip : 46151-3158
Country : US
Telephone Number : 765-342-3305
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2009
Last Update Date : 12/17/2009

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Directions to “ MRS. TRACI ARNOLD PTA” Practice Location

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