Provider Demographics
NPI:1134793268
Name:THARMAN, BLAINE (DC)
Entity type:Individual
Prefix:DR
First Name:BLAINE
Middle Name:
Last Name:THARMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 CLOCK TOWER PL
Mailing Address - Street 2:STE 110
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-6404
Mailing Address - Country:US
Mailing Address - Phone:785-456-4530
Mailing Address - Fax:
Practice Address - Street 1:2004 CLOCK TOWER PL STE 110
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-6404
Practice Address - Country:US
Practice Address - Phone:785-320-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0106129111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician