Provider Demographics
NPI:1770395246
Name:CONNECTION CHIROPRACTIC LLC
Entity type:Organization
Organization Name:CONNECTION CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMPLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-762-2558
Mailing Address - Street 1:163 RAINSONG DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:AR
Mailing Address - Zip Code:72730-8623
Mailing Address - Country:US
Mailing Address - Phone:501-762-2558
Mailing Address - Fax:
Practice Address - Street 1:1344 BENTON ST STE 2
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6325
Practice Address - Country:US
Practice Address - Phone:501-762-2558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty