Individual
JORI KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
211 E JACKSON ST, HUGO, OK 74743-4036
(580) 326-5279
(580) 326-8047
Mailing address
211 E JACKSON ST, HUGO, OK 74743-4036
(580) 326-5279
(580) 326-8047
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200493040A
—
OK
Enumeration date
11/05/2013
Last updated
02/07/2014
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