Healthcare Provider Details

I. General information

NPI: 1871505727
Provider Name (Legal Business Name): THOMAS L ARNOLD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 UINTA DR
GREEN RIVER WY
82935-5055
US

IV. Provider business mailing address

705 UINTA DR
GREEN RIVER WY
82935-5055
US

V. Phone/Fax

Practice location:
  • Phone: 307-875-1926
  • Fax: 307-875-5223
Mailing address:
  • Phone: 307-875-1926
  • Fax: 307-875-5223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number640
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: