Provider Demographics
NPI:1407240161
Name:ARNOLD, KELLI (ATC)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W3340 #3325 RD
Mailing Address - Street 2:
Mailing Address - City:CARNEY
Mailing Address - State:MI
Mailing Address - Zip Code:49812
Mailing Address - Country:US
Mailing Address - Phone:906-241-9244
Mailing Address - Fax:
Practice Address - Street 1:109 N BIRCH ST
Practice Address - Street 2:
Practice Address - City:KALKASKA
Practice Address - State:MI
Practice Address - Zip Code:49646-8343
Practice Address - Country:US
Practice Address - Phone:906-241-9244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer