Provider Demographics
NPI:1033251723
Name:ARNOLD, ELIZABETH LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LEE
Last Name:ARNOLD
Suffix:
Gender:F
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:P.O. BOX 3
Mailing Address - Street 2:
Mailing Address - City:MARCELINE
Mailing Address - State:MO
Mailing Address - Zip Code:64658-0003
Mailing Address - Country:US
Mailing Address - Phone:660-376-9355
Mailing Address - Fax:660-376-3733
Practice Address - Street 1:213 N. MAIN STREET USA
Practice Address - Street 2:
Practice Address - City:MARCELINE
Practice Address - State:MO
Practice Address - Zip Code:64658-1292
Practice Address - Country:US
Practice Address - Phone:660-376-9355
Practice Address - Fax:660-376-3733
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003026718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000047019Medicare ID - Type Unspecified
U99321Medicare UPIN