Healthcare Provider Details

I. General information

NPI: 1467990911
Provider Name (Legal Business Name): KATHLEEN HEATHER FITZGERALD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2017
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1454 E MAPLE ST
NORTH CANTON OH
44720-2634
US

IV. Provider business mailing address

1454 E MAPLE ST
NORTH CANTON OH
44720-2634
US

V. Phone/Fax

Practice location:
  • Phone: 330-353-8875
  • Fax:
Mailing address:
  • Phone: 330-353-8875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011840
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: