Provider Demographics
NPI:1760604771
Name:ARNOLD, KATHY LEE (MA, ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LEE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MA, ATC, LAT
Other - Prefix:MISS
Other - First Name:KATHY
Other - Middle Name:LEE
Other - Last Name:KEMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:210 AVIS AVE NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-3687
Mailing Address - Country:US
Mailing Address - Phone:330-833-2497
Mailing Address - Fax:
Practice Address - Street 1:4645 BELPAR ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3602
Practice Address - Country:US
Practice Address - Phone:330-493-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0021442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer