Provider Demographics
NPI:1427469808
Name:ARNOLD, TIMOTHY (ATC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 HIDDEN HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-9998
Mailing Address - Country:US
Mailing Address - Phone:405-229-5780
Mailing Address - Fax:
Practice Address - Street 1:825 EAST ROBINSON STREET
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-9998
Practice Address - Country:US
Practice Address - Phone:405-229-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer