Provider Demographics
NPI:1881893733
Name:ARNOLD, KAELEN CHRISTINE (PT)
Entity type:Individual
Prefix:
First Name:KAELEN
Middle Name:CHRISTINE
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 1:2657 LENOX RD NE
Mailing Address - Street 2:APARTMENT 182
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3191
Mailing Address - Country:US
Mailing Address - Phone:404-290-8669
Mailing Address - Fax:
Practice Address - Street 1:1995 N PARK PL SE
Practice Address - Street 2:SUITE 230
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2004
Practice Address - Country:US
Practice Address - Phone:770-850-0390
Practice Address - Fax:770-818-9762
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009132225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist