IndividualActive
Kristopher Ketchum, CERTIFIED PEDORTHIST
NPI 1093422388 · Pedorthist · Paw Paw, MI
Provider details
- NPI number
- 1093422388
- Entity type
- Individual
- Primary specialty
- PedorthistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CERTIFIED PEDORTHIST
- Sex
- Male
- Sole proprietor
- Yes
- License
- 3509 (MI)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
31863 29th St
Paw Paw, MI 49079-8422
Phone: (269) 873-3541
Approximate (ZIP-level) locationGet directions
Mailing address
31863 29th St
Paw Paw, MI 49079-8422
Registry dates
- Enumerated
- 2022-11-04
- Last updated
- 2022-11-04
- Certified
- 2022-11-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.