Provider Demographics
NPI:1407983885
Name:ARNOLD, MITCHELL SHEA (DC)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:SHEA
Last Name:ARNOLD
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 1:3894 DUE WEST RD NW STE 210
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1072
Mailing Address - Country:US
Mailing Address - Phone:678-285-1100
Mailing Address - Fax:678-285-1102
Practice Address - Street 1:3894 DUE WEST RD NW STE 210
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1072
Practice Address - Country:US
Practice Address - Phone:678-285-1100
Practice Address - Fax:678-285-1102
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006422111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHRVMedicare PIN
GAU99912Medicare UPIN