Individual
KELLY KETCHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, A.T.C.
Contact information
Practice address
5900 ELVAS AVE, SACRAMENTO, CA 95819-4341
(530) 409-4424
Mailing address
PO BOX 356, SHINGLE SPRINGS, CA 95682-0356
(530) 409-4424
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/27/2014
Last updated
12/27/2014
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