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Individual

LECEA A KETZLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
379 METHODIST RD, WESTBROOK, ME 04092
(207) 854-4638
Mailing address
PO BOX 810, WESTBROOK, ME 04098-0810
(207) 854-1544
(207) 854-1516

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
1885
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1699888958
NPI
ME
Enumeration date
08/17/2006
Last updated
09/24/2008
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