Individual
KATHLEEN ANNE KETCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 S KEENE ST, COLUMBIA, MO 65201-7199
(573) 443-2402
(573) 443-0574
Mailing address
1 S KEENE ST, COLUMBIA, MO 65201-7199
(573) 443-2402
(573) 443-0574
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2013005293
MO
Other
Enumeration date
03/25/2013
Last updated
05/09/2014
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