Provider Demographics
NPI:1720091564
Name:ARNDT, KEVIN DOUGLAS (DC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:DOUGLAS
Last Name:ARNDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:115 1ST AVE NW
Mailing Address - City:WINNEBAGO
Mailing Address - State:MN
Mailing Address - Zip Code:56098
Mailing Address - Country:US
Mailing Address - Phone:507-893-4412
Mailing Address - Fax:507-893-4912
Practice Address - Street 1:115 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:MN
Practice Address - Zip Code:56098
Practice Address - Country:US
Practice Address - Phone:507-893-4412
Practice Address - Fax:507-893-4912
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN001610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0250OtherHEALTH SERVICE MANAGEMENT
230928OtherCHIROCARE MGMT INC
MN42019AROtherBLUE CROSS BLUE SHIELD
T65255Medicare UPIN