Organization
HEALTHSOURCE OF MANSFIELD TEXAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
M BRANDON PETTKE DC (MANAGER)
(682) 518-9393
Entity
Organization
Contact information
Practice address
121 W DEBBIE LN, STE 115, MANSFIELD, TX 76063-8941
(682) 518-9393
(682) 518-9398
Mailing address
121 W DEBBIE LN, STE 115, MANSFIELD, TX 76063-8941
(682) 518-9393
(682) 518-9398
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
12/09/2011
Last updated
09/12/2013
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