MEDICARE: SAMANTHA ORTH DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PTL.0020760	CO

General Provider Information

NPI Number	:	1346089661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA ORTH DPT

Provider Business Mailing Address
First Line	:	4350 WADSWORTH BLVD STE 200
Second Line	:
City	:	WHEAT RIDGE
State	:	CO
Zip	:	80033-4634
Country	:	US
Telephone Number	:	763-237-4229
Fax Number	:

Provider Business Practice Location Address
First Line	:	1161 MANNING AVE N
Second Line	:
City	:	LAKE ELMO
State	:	MN
Zip	:	55042-9607
Country	:	US
Telephone Number	:	763-237-4229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	08/29/2025

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Directions to “ SAMANTHA ORTH DPT” Practice Location

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