Healthcare Provider Details

I. General information

NPI: 1760138598
Provider Name (Legal Business Name): CARLYN GREENHALGH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7686 WALNUT ST
OMAHA NE
68124-1717
US

IV. Provider business mailing address

4381 S 154TH ST
OMAHA NE
68137-5147
US

V. Phone/Fax

Practice location:
  • Phone: 402-659-0725
  • Fax:
Mailing address:
  • Phone: 308-390-5236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4999
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: