Healthcare Provider Details

I. General information

NPI: 1619962271
Provider Name (Legal Business Name): PETER DANIEL WORKMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E ELM ST
LINCOLN KS
67455-2004
US

IV. Provider business mailing address

102 E ELM ST
LINCOLN KS
67455-2004
US

V. Phone/Fax

Practice location:
  • Phone: 785-524-4371
  • Fax: 785-524-4375
Mailing address:
  • Phone: 785-524-4371
  • Fax: 785-524-4375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3931
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: