Provider Demographics
NPI:1932634383
Name:KAPLAN, DUSTIN ROBERT (AT, LMT, ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:ROBERT
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:AT, LMT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 NORTHRIDGE OVAL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-3259
Mailing Address - Country:US
Mailing Address - Phone:440-666-4004
Mailing Address - Fax:
Practice Address - Street 1:24775 AURORA RD
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1759
Practice Address - Country:US
Practice Address - Phone:440-666-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0043722255A2300X
OH33.021965225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist