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General NPI Number Information
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NPI Number | 1114029758
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Entity Type | Individual
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Provider Name | ANGELIA MARIE ARNOLD RD, LD
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Gender | Female
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Dates
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Enumeration Date | 09/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1763 E MAIN ST
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City | DOTHAN
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State | AL
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Zip | 36301-3045
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Country | US
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Telephone | 334-793-3319
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Fax | 334-793-2291
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Provider Business Mailing Address
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Address Line | 426 BLAKE DR
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City | OZARK
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State | AL
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Zip | 36360-6218
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Country | US
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Telephone | 334-796-1178
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Fax | 334-793-2404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | 169ST
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License Number State | AL
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