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Individual
DR. CHRIS A KETCHMARK
Active
Individual
DR. CHRIS A KETCHMARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3570
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00B12NO
BCBSM
MN
01
—
0370
HSM
—
01
—
4400039
MEDICA
MN
Enumeration date
10/17/2006
Last updated
07/09/2007
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