Healthcare Provider Details

I. General information

NPI: 1124146394
Provider Name (Legal Business Name): JCAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8-C WILSON FARM ROAD
GREENBRIER AR
72058-8200
US

IV. Provider business mailing address

PO BOX 1082
GREENBRIER AR
72058-1082
US

V. Phone/Fax

Practice location:
  • Phone: 501-679-6065
  • Fax: 501-679-7311
Mailing address:
  • Phone: 501-679-6065
  • Fax: 501-679-7311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1553
License Number StateAR

VIII. Authorized Official

Name: DR. JOHN JOE CRUM
Title or Position: OWNER
Credential: D.C.
Phone: 501-679-6065