Individual
DAVID W KETTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
89 BLACKBERRY TRL, AURORA, IL 60506-4261
(630) 346-3073
Mailing address
89 BLACKBERRY TRL, AURORA, IL 60506-4261
(630) 346-3073
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
041307853
IL
Other
Enumeration date
09/12/2007
Last updated
04/08/2010
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