Healthcare Provider Details

I. General information

NPI: 1538332515
Provider Name (Legal Business Name): JENNIFER BONDS ARNOLD P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 MAIN ST
MEADVILLE MS
39653
US

IV. Provider business mailing address

PO BOX 783
MEADVILLE MS
39653-0783
US

V. Phone/Fax

Practice location:
  • Phone: 601-384-1898
  • Fax:
Mailing address:
  • Phone: 601-384-1898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT3322
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: