Individual
CHRISTOPHER FREDERICK KETCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 NAVARRE PL STE 4440, SOUTH BEND, IN 46601-1171
(574) 647-5300
(574) 647-5305
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
02005317A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014121
—
IN
Enumeration date
06/17/2014
Last updated
10/11/2023
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