MEDICARE: DR. BRIAN ANTHONY ARNOLD D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301004762	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11270964	OTHER	MI	MICHIGAN PROVIDER ID #
2	2301004762	OTHER	MI	MICHIGAN LICENCE NUMBER

General Provider Information

NPI Number	:	1093714081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ANTHONY ARNOLD D.C.

Provider Business Mailing Address
First Line	:	31930 HARPER AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48082-1418
Country	:	US
Telephone Number	:	586-296-0991
Fax Number	:	586-296-7611

Provider Business Practice Location Address
First Line	:	31930 HARPER AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48082
Country	:	US
Telephone Number	:	586-296-0991
Fax Number	:	586-296-7611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	05/21/2018

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