| NPI | 1245318492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER J WAKEMAN President Owner 386-673-0201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH1429) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH5831) |
| 225100000X Physical Therapist (Licence: FL PT22240) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL CH1429) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL CH5831) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2018-04-03 |