Individual
ADAM ROBERT KETTERHAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT DPT
Contact information
Practice address
5340 WASHINGTON AVE, MOUNT PLEASANT, WI 53406
(262) 638-1272
(262) 638-1287
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
(630) 928-5080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12113-24
WI
225100000X
Physical Therapist
9895
AZ
Other
Enumeration date
07/25/2012
Last updated
01/04/2019
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