Individual
CASEY KETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5526 85TH AVE, EVART, MI 49631-8778
(989) 772-1261
Mailing address
209 E CHIPPEWA ST, MOUNT PLEASANT, MI 48858-1609
(989) 772-1261
(989) 772-1300
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703119504
MI
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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