Healthcare Provider Details

I. General information

NPI: 1780442269
Provider Name (Legal Business Name): LUKE GREGORY ARROWOOD ATC/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 E STATE ST
ALGONA IA
50511-2676
US

IV. Provider business mailing address

50 E OAK RIDGE DR
ALGONA IA
50511-1039
US

V. Phone/Fax

Practice location:
  • Phone: 515-890-8306
  • Fax:
Mailing address:
  • Phone: 515-890-8306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number088246
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: