Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 07-980 | AZ |
NPI | 1114186467 |
---|---|
Provider Name | Dr. Fred Arnold |
First Address | Mesa, AZ 85207-7258 |
Second Address | Mesa, AZ 85215-2903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 03/06/2008 |