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General NPI Number Information
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NPI Number | 1013212844
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Entity Type | Organization
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Legal Business Name | ALWAYS BELIEVE IN YOUR DREAMS, LLC
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 765 PARK AVE
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City | MEADVILLE
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State | PA
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Zip | 16335-2546
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Country | US
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Telephone | 814-337-0128
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Fax | 814-337-0164
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Provider Business Mailing Address
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Address Line | 765 PARK AVE
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City | MEADVILLE
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State | PA
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Zip | 16335-2546
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Country | US
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Telephone | 814-337-0128
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Fax | 814-337-0164
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JON MARK KETCHAM
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Credential |
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Telephone | 814-337-0128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC006808L
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License Number State | PA
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