Individual
ADAM KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
56 SMITH ST APT 2, BANGOR, ME 04401-4715
(207) 404-0829
Mailing address
56 SMITH ST APT 2, BANGOR, ME 04401-4715
(207) 404-0829
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/16/2020
Last updated
05/16/2020
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