Provider Demographics
NPI:1750941175
Name:BAALMANN, THOMAS J (PT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:BAALMANN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 N RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-2995
Mailing Address - Country:US
Mailing Address - Phone:316-227-1767
Mailing Address - Fax:844-788-4005
Practice Address - Street 1:1443 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2995
Practice Address - Country:US
Practice Address - Phone:316-227-1767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS11-06205OtherKANSAS STATE BOARD OF HEALING ARTS