Healthcare Provider Details

I. General information

NPI: 1255070488
Provider Name (Legal Business Name): SAMUEL FARMER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13659 E 104TH AVE UNIT 300
COMMERCE CITY CO
80022-9402
US

IV. Provider business mailing address

3424 HOPKINS ST
NASHVILLE TN
37215-1508
US

V. Phone/Fax

Practice location:
  • Phone: 720-506-5340
  • Fax:
Mailing address:
  • Phone: 615-887-8590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14286
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP052981T
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP058938T
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: