Individual
CHARLES KETTENRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5130 SAN FRANCISCO RD NE STE B, ALBUQUERQUE, NM 87109-4618
(505) 823-2411
Mailing address
6564 LOS PUEBLOS PL NW, ALBUQUERQUE, NM 87114-4451
(801) 671-4600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/17/2021
Last updated
10/27/2021
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