Organization
KELLOGG MOVEMENT PERFORMANCE THEARPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLTON KELLOGG PT, DPT, CSCS (OWNER, PHYSICAL THERAPIST)
(330) 979-7315
Entity
Organization
Contact information
Practice address
1956 W PROSPECT RD, ASHTABULA, OH 44004-6424
(330) 979-7315
Mailing address
6804 KINSMAN NICKERSON RD, KINSMAN, OH 44428-9511
(330) 979-7315
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588340814
—
PA
Enumeration date
05/14/2025
Last updated
05/14/2025
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