Healthcare Provider Details

I. General information

NPI: 1780800680
Provider Name (Legal Business Name): KRIS CLYDE ARNOLD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6009 BUSINESS 220
BEDFORD PA
15522-7646
US

IV. Provider business mailing address

6009 BUSINESS 220
BEDFORD PA
15522-7646
US

V. Phone/Fax

Practice location:
  • Phone: 814-624-0606
  • Fax: 814-624-2455
Mailing address:
  • Phone: 814-624-0606
  • Fax: 814-624-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-007841-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: