Provider Demographics
NPI:1619962271
Name:WORKMAN, PETER DANIEL (DC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:DANIEL
Last Name:WORKMAN
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 1:102 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:KS
Mailing Address - Zip Code:67455-2004
Mailing Address - Country:US
Mailing Address - Phone:785-524-4371
Mailing Address - Fax:785-524-4375
Practice Address - Street 1:102 E ELM ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:KS
Practice Address - Zip Code:67455-2004
Practice Address - Country:US
Practice Address - Phone:785-524-4371
Practice Address - Fax:785-524-4375
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO3931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS023597OtherBLUE CROSS BLUE SHIELD
T90170Medicare UPIN
KS023597Medicare ID - Type Unspecified