Provider Demographics
NPI:1902538598
Name:ODVODY, SUZANNE MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARIE
Last Name:ODVODY
Suffix:
Gender:
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 1:11665 W RADCLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-1410
Mailing Address - Country:US
Mailing Address - Phone:303-503-8806
Mailing Address - Fax:
Practice Address - Street 1:5600 S QUEBEC ST STE 107A
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2201
Practice Address - Country:US
Practice Address - Phone:303-689-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.00184352251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic