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Individual

DR. JACOB K KETTLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D., BCOP

Contact information

Practice address
4801 E LINWOOD BLVD, KANSAS CITY, MO 64128-2226
(816) 861-4700
Mailing address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 884-6399

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2007028941
MO

Other

Enumeration date
12/14/2007
Last updated
06/17/2015
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