Healthcare Provider Details

I. General information

NPI: 1396588281
Provider Name (Legal Business Name): SAMANTHA WAIT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23770 E SMOKY HILL RD
AURORA CO
80016-3089
US

IV. Provider business mailing address

5162 REMINGTON AVE
FIRESTONE CO
80504-3549
US

V. Phone/Fax

Practice location:
  • Phone: 720-478-0700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0021081
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1396954
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: