Healthcare Provider Details

I. General information

NPI: 1912834169
Provider Name (Legal Business Name): JAYDEN EXZABE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 US-65 UNIT 2
CLINTON AR
72031
US

IV. Provider business mailing address

PO BOX 1019
CLINTON AR
72031-1019
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-2999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number12485
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: