Provider Demographics
NPI:1689624546
Name:ARNOLD, COURTNEY RAE (PT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RAE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 CORAL BARK PL
Mailing Address - Street 2:APT. 315
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-7747
Mailing Address - Country:US
Mailing Address - Phone:317-228-0624
Mailing Address - Fax:
Practice Address - Street 1:2160 W 86TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1904
Practice Address - Country:US
Practice Address - Phone:317-871-3535
Practice Address - Fax:317-871-3540
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008724A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist