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General NPI Number Information
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NPI Number | 1437623576
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Entity Type | Individual
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Provider Name | KAITLYN MARIE DZUROFF PT, DPT, AT
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Gender | Female
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Dates
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Enumeration Date | 01/11/2019
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 4645 BELPAR ST NW
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City | CANTON
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State | OH
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Zip | 44718-3602
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Country | US
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Telephone | 330-493-4210
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Fax |
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Provider Business Mailing Address
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Address Line | 4282 SPRINGDALE RD
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City | UNIONTOWN
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State | OH
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Zip | 44685-7709
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Country | US
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Telephone | 440-539-4997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT006798
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT020526
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License Number State | OH
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