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1609180041
DAVID SCOTT KETCHAM
RAWLINS, WY
NPI
1609180041
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY CAP -19)
Enumeration Date
2010-07-27
Last Update Date
2010-07-27
Business Address
-- DAVID SCOTT KETCHAM BA
143 SONORA CT
RAWLINS, WY 82301-5115
Phone number: 307-324-7156
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Mailing Address
-- DAVID SCOTT KETCHAM BA
143 SONORA CT
RAWLINS, WY 82301-5115
Phone number: 307-324-7156
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