Provider Demographics
NPI:1003488834
Name:MCEVOY, CASEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:MCEVOY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6556 CRYSTAL DOWNS DR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-7170
Mailing Address - Country:US
Mailing Address - Phone:970-214-5275
Mailing Address - Fax:
Practice Address - Street 1:7292 GREENRIDGE RD STE 104
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-8193
Practice Address - Country:US
Practice Address - Phone:970-292-8473
Practice Address - Fax:720-464-6077
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist