Provider Demographics
NPI:1548346273
Name:ARNOLD, MICHAEL W (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 E KEARNEY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-4987
Mailing Address - Country:US
Mailing Address - Phone:417-862-0077
Mailing Address - Fax:417-862-5938
Practice Address - Street 1:2239 E KEARNEY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-4987
Practice Address - Country:US
Practice Address - Phone:417-862-0077
Practice Address - Fax:417-862-5938
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO00030675Medicare PIN