Healthcare Provider Details

I. General information

NPI: 1285558601
Provider Name (Legal Business Name): EVELYN KATHLEEN O'DONAHUE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4617 W 20TH ST UNIT A
GREELEY CO
80634-3207
US

IV. Provider business mailing address

4617 W 20TH ST UNIT A
GREELEY CO
80634-3207
US

V. Phone/Fax

Practice location:
  • Phone: 970-352-9022
  • Fax:
Mailing address:
  • Phone: 970-352-9022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12788
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP060809T
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: