Healthcare Provider Details

I. General information

NPI: 1144154782
Provider Name (Legal Business Name): SAMANTHA DEYOUNG PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 65TH AVE STE C
GREELEY CO
80634-7946
US

IV. Provider business mailing address

4650 ROYAL VISTA CIR STE 100
WINDSOR CO
80528-9321
US

V. Phone/Fax

Practice location:
  • Phone: 970-702-2507
  • Fax: 970-360-1061
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0021340
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: