Provider Demographics
NPI:1497572317
Name:ARNOLD, MARK A
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38380 NORTH LN APT F102
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7420
Mailing Address - Country:US
Mailing Address - Phone:440-679-6642
Mailing Address - Fax:
Practice Address - Street 1:38380 NORTH LN APT F102
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-7420
Practice Address - Country:US
Practice Address - Phone:440-679-6642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty