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1861086555
TYLER LANE KETCHEM
PARKERSBURG, WV
NPI
1861086555
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-02-24
Last Update Date
2021-02-24
Business Address
TYLER LANE KETCHEM
4421 EMERSON AVE STE 204
PARKERSBURG, WV 26104-1200
Phone number: 304-295-0890
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Mailing Address
TYLER LANE KETCHEM
4421 EMERSON AVE STE 204
PARKERSBURG, WV 26104-1200
Phone number: 304-295-0890
Copy
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