Individual
MR. RONALD R KETELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3981 WASATCH BLVD, SALT LAKE CITY, UT 84124-2247
(801) 213-9500
Mailing address
PO BOX 510721, SALT LAKE CITY, UT 84151-0721
(801) 587-6600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102163-1206
UT
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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