Provider Demographics
NPI:1700170263
Name:THARP, DAVID ANDREW II (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANDREW
Last Name:THARP
Suffix:II
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 1:1448 MARION WALDO RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-7422
Mailing Address - Country:US
Mailing Address - Phone:740-386-6580
Mailing Address - Fax:
Practice Address - Street 1:491 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4244
Practice Address - Country:US
Practice Address - Phone:740-386-6580
Practice Address - Fax:740-386-6586
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4187Medicaid
OH4187Medicare PIN