Organization
HEALTHSOURCE OF FRISCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
M. BRANDON PETTKE D.C. PA (PRESIDENT/OWNER)
(817) 291-1816
Entity
Organization
Contact information
Practice address
7010 PRESTON RD, SUITE 100, FRISCO, TX 75034-5869
(469) 633-1155
Mailing address
7010 PRESTON RD, SUITE 100, FRISCO, TX 75034-5869
(469) 633-1155
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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