Healthcare Provider Details

I. General information

NPI: 1962654848
Provider Name (Legal Business Name): MELISSA MARIE ARNOLD D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4646 N SHALLOWFORD RD
ATLANTA GA
30338-6308
US

IV. Provider business mailing address

4646 N SHALLOWFORD RD
ATLANTA GA
30338-6308
US

V. Phone/Fax

Practice location:
  • Phone: 770-676-6000
  • Fax: 678-990-0941
Mailing address:
  • Phone: 770-676-6000
  • Fax: 678-990-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR006247
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberCHIR006247
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: