Healthcare Provider Details

I. General information

NPI: 1437623576
Provider Name (Legal Business Name): KAITLYN MARIE DZUROFF PT, DPT, AT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 BELPAR ST NW
CANTON OH
44718-3602
US

IV. Provider business mailing address

4282 SPRINGDALE RD
UNIONTOWN OH
44685-7709
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-4210
  • Fax:
Mailing address:
  • Phone: 440-539-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT006798
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT020526
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: