Healthcare Provider Details

I. General information

NPI: 1366473639
Provider Name (Legal Business Name): ARLEN EARLE SCHOLL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 E INDIAN SCHOOL RD STE C
PHOENIX AZ
85018-5156
US

IV. Provider business mailing address

3520 E INDIAN SCHOOL RD STE C
PHOENIX AZ
85018-5156
US

V. Phone/Fax

Practice location:
  • Phone: 602-954-9444
  • Fax: 602-954-1248
Mailing address:
  • Phone: 602-954-9444
  • Fax: 602-954-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number5891
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: