Individual
DR. ADAM J KETTELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
313 W PEARL ST, ATKINSON, NE 68713-4958
(402) 925-2669
(402) 925-2306
Mailing address
PO BOX 995, ATKINSON, NE 68713-0995
(402) 925-2669
(402) 925-2306
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1218
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025583200
—
NE
Enumeration date
07/19/2006
Last updated
12/21/2009
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