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Organization
WAKEMAN CHIROPRACTIC , PA
Active
Organization
WAKEMAN CHIROPRACTIC , PA
Active
Other names
Wakeman Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
PETER J WAKEMAN DC (OWNER/PRESIDENT)
(386) 673-0201
Entity
Organization
Contact information
Practice address
305 MEMORIAL MEDICAL PKWY STE 305, DAYTONA BEACH, FL 32117-5169
(386) 673-0201
(386) 677-8143
Mailing address
305 MEMORIAL MEDICAL PKWY STE 305, DAYTONA BEACH, FL 32117-5169
(386) 673-0201
(386) 677-8143
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH1429
FL
111N00000X
Chiropractor
CH5831
FL
225100000X
Physical Therapist
PT22240
FL
332B00000X
Durable Medical Equipment & Medical Supplies
CH1429
FL
332B00000X
Durable Medical Equipment & Medical Supplies
CH5831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74592
BCBS GROUP NUMBER
FL
01
—
DB4204
RAILROAD MEDICARE GROUP PIN
FL
Enumeration date
11/02/2006
Last updated
02/05/2025
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