=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306203542
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARNOLD CHIROPRACTIC HEALTH CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2016
-----------------------------------------------------
Last Update Date | 01/19/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2118 E ATLANTIC BLVD
-----------------------------------------------------
City | POMPANO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33062-5208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-786-1098
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2118 E ATLANTIC BLVD
-----------------------------------------------------
City | POMPANO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33062-5208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-786-1098
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KENNETH ARNOLD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-786-1098
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH0004685
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------