Provider Demographics
NPI:1063710135
Name:ARNOLD, ADRIENNE (RMT)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 KELLY JOHNSON BLVD
Mailing Address - Street 2:STE 250
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3951
Mailing Address - Country:US
Mailing Address - Phone:719-266-6661
Mailing Address - Fax:
Practice Address - Street 1:1271 KELLY JOHNSON BLVD
Practice Address - Street 2:STE 250
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3951
Practice Address - Country:US
Practice Address - Phone:719-266-6661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3316225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist