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General NPI Number Information
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NPI Number | 1386712263
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Entity Type | Individual
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Provider Name | JOSEPH MARK CRUM DC, CCRD, CCSP
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 359 COMMONWEALTH AVE STE 120
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City | BRISTOL
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State | VA
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Zip | 24201-3868
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Country | US
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Telephone | 276-669-0969
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Fax | 276-669-0969
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Provider Business Mailing Address
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Address Line | 359 COMMONWEALTH AVE STE 120
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City | BRISTOL
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State | VA
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Zip | 24201-3868
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Country | US
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Telephone | 276-669-0969
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Fax | 276-669-0969
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 0104001471
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License Number State | VA
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