Individual
GREGORY EARL KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
806 RUMFORD COURT, FORT COLLINS, CO 80525
(970) 377-0992
Mailing address
806 RUMFORD COURT, FORT COLLINS, CO 80525
(970) 377-0992
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9620048
CO
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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