Healthcare Provider Details

I. General information

NPI: 1710495775
Provider Name (Legal Business Name): SAMANTHA JANE HARMON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 YOSEMITE ST STE 100
DENVER CO
80238-4481
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 720-516-8900
  • Fax:
Mailing address:
  • Phone: 970-624-1103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL0015343
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: