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General NPI Number Information
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NPI Number | 1871706820
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Entity Type | Individual
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Provider Name | HARLAN DALE ARNOLDM ATC
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1001 ISAACS STREET DR.
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City | OREGON
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State | OH
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Zip | 43604
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Country | US
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Telephone | 419-696-7203
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Fax |
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Provider Business Mailing Address
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Address Line | 201 RIDGE ST
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2417
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Country | US
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Telephone | 419-354-6822
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT 000366
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License Number State | OH
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