Individual
MR. KENNETH PAUL COLLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2120 N 400 E, NORTH OGDEN, UT 84414-7238
(801) 668-3500
Mailing address
3578 N. 875 E., NORTH OGDEN, UT 84414
(801) 668-3500
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
103041-2401
UT
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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