Provider Demographics
NPI:1437369436
Name:ARNOLD KINESIOLOGY CENTER PA
Entity Type:Organization
Organization Name:ARNOLD KINESIOLOGY CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-425-0035
Mailing Address - Street 1:2260 N RIDGE RD
Mailing Address - Street 2:200
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1132
Mailing Address - Country:US
Mailing Address - Phone:316-425-0035
Mailing Address - Fax:316-425-0045
Practice Address - Street 1:2260 N RIDGE RD
Practice Address - Street 2:200
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1132
Practice Address - Country:US
Practice Address - Phone:316-425-0035
Practice Address - Fax:316-425-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062279Medicare ID - Type Unspecified