Provider Demographics
NPI:1629132964
Name:ARVOLD, DANIEL T (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:ARVOLD
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 1:600 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:WI
Mailing Address - Zip Code:54730
Mailing Address - Country:US
Mailing Address - Phone:715-962-2393
Mailing Address - Fax:715-962-2395
Practice Address - Street 1:600 MAIN ST.
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:WI
Practice Address - Zip Code:54730
Practice Address - Country:US
Practice Address - Phone:715-962-2393
Practice Address - Fax:715-962-2395
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIU74339Medicare UPIN