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General NPI Number Information
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NPI Number | 1033791249
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Entity Type | Individual
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Provider Name | JEFFREY TANNER CRUMP DC
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Gender | Male
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 161 LEXINGTON GREEN CIR STE B15
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City | LEXINGTON
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State | KY
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Zip | 40503-3379
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Country | US
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Telephone | 719-487-3170
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Fax |
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Provider Business Mailing Address
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Address Line | 508 FRANKLIN CT
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City | ASHLAND
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State | KY
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Zip | 41101-2152
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Country | US
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Telephone | 606-923-6208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 268716
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License Number State | KY
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