Healthsource of Mansfield Texas LLC

NPI #1629346382 in Mansfield, Texas

Provider Information

NPI Number: 1629346382
Entity Type: Organization
Organization Name: Healthsource of Mansfield Texas LLC
Primary Specialty: Chiropractor
Enumeration Date: Dec 9, 2011
Last Updated: Sep 12, 2013

Practice Location

Address: 121 W DEBBIE LN
Address 2: STE 115
City: Mansfield
State: Texas
ZIP Code: 76063-8941
Phone: (682) 518-9393

Authorized Official

Name: M BRANDON PETTKE, DC
Title: MANAGER
Phone: (682) 518-9393

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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