Individual
JACK KETTERING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
930 W HILL FIELD RD, A, LAYTON, UT 84041-4662
(801) 366-3040
Mailing address
899 CARTER DR, RIVERDALE, UT 84405-2630
(480) 543-0038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/09/2011
Last updated
10/14/2013
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