Provider Demographics
NPI:1801057799
Name:ARNOLD, LAUREN (PT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
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 1:3133 GOOD SHEPHERD WAY
Mailing Address - Street 2:OUTPATIENT THERAPY
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-7921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3133 GOOD SHEPHERD WAY
Practice Address - Street 2:OUTPATIENT THERAPY
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-7921
Practice Address - Country:US
Practice Address - Phone:903-323-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31058092251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic