Provider Demographics
NPI:1770829780
Name:ARNOLD, LEVI R (DC)
Entity Type:Individual
Prefix:DR
First Name:LEVI
Middle Name:R
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 1:331 KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:STURGEON BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54235-2419
Mailing Address - Country:US
Mailing Address - Phone:920-743-6919
Mailing Address - Fax:920-746-0619
Practice Address - Street 1:331 KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-2419
Practice Address - Country:US
Practice Address - Phone:920-743-6919
Practice Address - Fax:920-746-0619
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4910-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor