Individual
DEREK KENNETH KETCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
504 E BUSINESS WAY, SHARONVILLE, OH 45241-2374
(513) 354-3800
Mailing address
4369 COACH LIGHT TRL, DAYTON, OH 45424-8042
(419) 513-9368
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-05036
OH
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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