Healthcare Provider Details

I. General information

NPI: 1679358972
Provider Name (Legal Business Name): JRC GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/28/2023
Certification Date: 08/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5624 N CREASY SPRINGS RD
COLUMBIA MO
65202-7034
US

IV. Provider business mailing address

5624 N CREASY SPRINGS RD
COLUMBIA MO
65202-7034
US

V. Phone/Fax

Practice location:
  • Phone: 660-383-6858
  • Fax:
Mailing address:
  • Phone: 660-383-6858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JORDAN CHAMBERS
Title or Position: OWNER
Credential:
Phone: 816-456-0160