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Mr. Kristopher Casey Ketchum, CERTIFIEDPEDORTHIST
Pedorthist in Paw Paw, Michigan
NPI 1093422388

Kristopher Casey Ketchum is a Pedorthist based in Paw Paw, MI. Kristopher Casey Ketchum practices in Paw Paw, MI and has the professional credentials of CERTIFIEDPEDORTHIST. The NPI Number for Kristopher Casey Ketchum is 1093422388 and holds a License No. 3509 (Michigan).

The current practice location address for Kristopher Casey Ketchum is 31863 29Th St, Paw Paw, MI and can be reached out via phone at 269-873-3541.

Location: 31863 29Th St, Paw Paw, MI, 49079-8422
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093422388
Provider Name
Kristopher Casey Ketchum
Credential
CERTIFIEDPEDORTHIST
Provider Entity Type
Individual
Gender
Male
Address
31863 29Th St, Paw Paw, MI, 49079-8422
Phone Number
269-873-3541
Fax Number
Provider Enumeration Date
11/04/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
31863 29Th St
City
Paw Paw
State
Michigan
Zip
49079-8422
Phone Number
269-873-3541
Fax Number
person
Provider Business Mailing Address Details
Address
31863 29Th St
City
Paw Paw
State
Michigan
Zip
49079-8422
Phone Number
269-873-3541
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Pedorthist
Speciality
-
Taxonomy
224L00000X
License No.
3509 (Michigan)
Definition
An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.
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