Healthcare Provider Details

I. General information

NPI: 1598297822
Provider Name (Legal Business Name): BRIAN ARNOLD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11059 E BETHANY DR
AURORA CO
80014-2622
US

IV. Provider business mailing address

11059 E BETHANY DR
AURORA CO
80014-2622
US

V. Phone/Fax

Practice location:
  • Phone: 303-617-2300
  • Fax: 303-617-2365
Mailing address:
  • Phone: 303-617-2300
  • Fax: 303-617-2365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: