Provider Demographics
NPI:1386602654
Name:HOLMAN, NATHAN EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:EDWARD
Last Name:HOLMAN
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 1:2618 NORTH SHORE CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1078
Mailing Address - Country:US
Mailing Address - Phone:316-946-9595
Mailing Address - Fax:316-946-0553
Practice Address - Street 1:5800 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2840
Practice Address - Country:US
Practice Address - Phone:316-946-9595
Practice Address - Fax:316-946-0553
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03877111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician