Individual
MARK KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
3061 E 109TH AVE, NORTHGLENN, CO 80233-5475
(720) 271-0628
(303) 953-1217
Mailing address
3061 E 109TH AVE, NORTHGLENN, CO 80233-5475
(720) 271-0628
(303) 953-1217
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
176755
CO
Other
Enumeration date
12/22/2008
Last updated
12/22/2008
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