Individual
BRAD FACKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3301 SOUTHERN BLVD SE, SUITE 304, RIO RANCHO, NM 87124-2085
(505) 891-2280
Mailing address
3301 SOUTHERN BLVD SE, SUITE 304, RIO RANCHO, NM 87124-2085
(505) 891-2280
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1577
NM
Other
Enumeration date
04/02/2008
Last updated
09/11/2008
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