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NPI Code Detail

MEDICARE: KAITLIN SPARKS PT, DPT

MEDICARE: KAITLIN SPARKS PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT019078OH

General Provider Information

NPI Number : 1477205748
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN SPARKS PT, DPT
Provider Business Mailing Address
First Line : 16515 SEDALIA AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44135-4453
Country : US
Telephone Number : 419-239-7239
Fax Number :
Provider Business Practice Location Address
First Line : 1950 E 89TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2008
Country : US
Telephone Number : 216-444-8600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2022
Last Update Date : 01/19/2022

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Directions to “ KAITLIN SPARKS PT, DPT” Practice Location

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