Healthcare Provider Details

I. General information

NPI: 1104905066
Provider Name (Legal Business Name): PATRICIA ANN ARNOLD LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3529 BRANTLEY RD
MEMPHIS TN
38109-3705
US

IV. Provider business mailing address

3529 BRANTLEY RD
MEMPHIS TN
38109-3705
US

V. Phone/Fax

Practice location:
  • Phone: 901-230-5308
  • Fax:
Mailing address:
  • Phone: 901-230-5308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number0000005441
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: