Individual
DR. CHRIS A KETCHMARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 N COMMERCIAL AVE, SANDSTONE, MN 55072
(320) 245-2499
(320) 245-2539
Mailing address
301 N COMMERCIAL AVE, SANDSTONE, MN 55072
(320) 245-2499
(320) 245-2539
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3570
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00B12NO
BCBSM
MN
01
—
0370
HSM
—
01
—
4400039
MEDICA
MN
Enumeration date
10/17/2006
Last updated
07/09/2007
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