Healthcare Provider Details

I. General information

NPI: 1033341144
Provider Name (Legal Business Name): MATTHEW DAVID ARNIO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2009
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E LAKEWAY RD SUITE 100
GILLETTE WY
82718-6365
US

IV. Provider business mailing address

110 E LAKEWAY RD SUITE 100
GILLETTE WY
82718-6365
US

V. Phone/Fax

Practice location:
  • Phone: 307-670-9426
  • Fax: 605-717-7704
Mailing address:
  • Phone: 307-670-9426
  • Fax: 605-717-7704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4529-012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: