Organization
KELLOGG MOVEMENT PERFORMANCE THEARPY LLC
Active
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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