Individual
KAELA KETCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
600 NE WATER ST, PEORIA, IL 61603-4246
(309) 282-1604
Mailing address
6026 N TEAL WOOD CIR, PEORIA, IL 61615-2231
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.007250
IL
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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