Provider Demographics
NPI:1982114575
Name:FELTON, CELINA (AT, ATC)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:FELTON
Suffix:
Gender:F
Credentials:AT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 CLEVELAND AVE NW
Mailing Address - Street 2:ATTN: ATHLETICS
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3308
Mailing Address - Country:US
Mailing Address - Phone:440-409-9691
Mailing Address - Fax:330-471-8298
Practice Address - Street 1:8563 EDGERTON RD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-5645
Practice Address - Country:US
Practice Address - Phone:440-409-9691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0050662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer