Healthcare Provider Details

I. General information

NPI: 1700668043
Provider Name (Legal Business Name): JFC ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 10/20/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S BROAD ST
SAINT JO TX
76265
US

IV. Provider business mailing address

PO BOX 625
SAINT JO TX
76265-0625
US

V. Phone/Fax

Practice location:
  • Phone: 940-241-7174
  • Fax:
Mailing address:
  • Phone: 940-241-7174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFF CRIPPEN JR.
Title or Position: CLINIC DIRECTOR
Credential: DC
Phone: 214-755-7513