Provider Demographics
NPI:1770709859
Name:ARNOLD, RICHARD JONATHAN SR (PT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JONATHAN
Last Name:ARNOLD
Suffix:SR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6520 MOUNT MORIAH ROAD EXT
Mailing Address - Street 2:STE.131
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-8603
Mailing Address - Country:US
Mailing Address - Phone:615-419-2561
Mailing Address - Fax:
Practice Address - Street 1:6520 MOUNT MORIAH ROAD EXT
Practice Address - Street 2:STE.131
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-8603
Practice Address - Country:US
Practice Address - Phone:615-419-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist