Individual
GREGORY KETTELHAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
11990 HERITAGE OAK PL STE 11, AUBURN, CA 95603-2405
(530) 823-7532
Mailing address
1850 DOUGLAS BLVD STE 992, ROSEVILLE, CA 95661-3639
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
3058
CA
Other
Enumeration date
06/23/2015
Last updated
01/03/2022
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