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Organization

CROCKER CHIROPRACTIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACK D CROCKER D.C. (OWNER)
(417) 532-9166
Entity
Organization

Contact information

Practice address
464 N JEFFERSON AVE, LEBANON, MO 65536-2742
(417) 532-9166
(417) 532-9887
Mailing address
464 N JEFFERSON AVE, LEBANON, MO 65536-2742
(417) 532-9166
(417) 532-9887

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MO004819
MO

Other

Enumeration date
09/27/2011
Last updated
10/29/2025
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