Individual
MICHELLE KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
605 SW RUSTIC CIR, STUART, FL 34997-6233
(561) 762-3975
Mailing address
605 SW RUSTIC CIR, STUART, FL 34997-6233
(561) 762-3975
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA17487
FL
Other
Enumeration date
05/25/2020
Last updated
05/25/2020
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