MEDICARE: DR. ARTHUR LABELLE PLLC

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	111NS0005X	Sports Physician Chiropractor	3643651202	UT

General Provider Information

NPI Number	:	1811184799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. ARTHUR LABELLE PLLC

Provider Business Mailing Address
First Line	:	3070 RASMUSSEN RD
Second Line	:	SUITE #110
City	:	PARK CITY
State	:	UT
Zip	:	84098-5486
Country	:	US
Telephone Number	:	435-649-1230
Fax Number	:	435-604-8991

Provider Business Practice Location Address
First Line	:	3070 RASMUSSEN RD
Second Line	:	SUITE #110
City	:	PARK CITY
State	:	UT
Zip	:	84098-5486
Country	:	US
Telephone Number	:	435-649-1230
Fax Number	:	435-604-8991

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ARTHUR JAMES LABELLE
Credential	:	D.C.
Telephone Number	:	435-649-1230

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	09/25/2007

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