| Doctor Name: | MRS. JESSICA MARIE KELLOUGH |
| NPI Number: | 1811194087 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | PT-10744 |
| Business Practice Address: | 2270 Warrensburg Rd Delaware, OH - 430151336 |
| Business Phone Number: | 7403699614 |
| Business Fax Number: | 7403635881 |
| Mailing Address: | 638 Village Mill Dr, SUNBURY |
| State: | OH |
| Postal Code: | 430749393 |
| Phone Number: | 7409651737 |
| Fax Number: | |
| NPI Enumeration Date: | 06/29/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT-10744 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |