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General NPI Number Information
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NPI Number | 1013294065
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Entity Type | Organization
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Legal Business Name | HSC CHIROPRACTIC OF MCKINNEY LLC
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 09/13/2013
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Provider Practice Location Address
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Address Line | 6200 ELDORADO PKWY STE B
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City | MCKINNEY
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State | TX
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Zip | 75070-5624
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Country | US
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Telephone | 972-529-9911
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Fax | 972-529-9419
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Provider Business Mailing Address
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Address Line | 6200 ELDORADO PKWY STE B
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City | MCKINNEY
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State | TX
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Zip | 75070-5624
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Country | US
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Telephone | 972-529-9911
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Fax | 972-529-9419
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Authorized Official
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Title or Position | DC/MANAGER
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Name | DR. M BRANDON PETTKE
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Credential | DC
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Telephone | 972-529-9911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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