Provider Demographics
NPI:1134495070
Name:ARNOLD, PHILLIP BOOTH (PT)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:BOOTH
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 WEST ATHERTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123
Mailing Address - Country:US
Mailing Address - Phone:801-716-2289
Mailing Address - Fax:801-716-2290
Practice Address - Street 1:1018 ATHERTON DR
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-3470
Practice Address - Country:US
Practice Address - Phone:801-716-2289
Practice Address - Fax:801-716-2290
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist