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General NPI Number Information
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NPI Number | 1346089661
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Entity Type | Individual
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Provider Name | SAMANTHA ORTH DPT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 1161 MANNING AVE N
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City | LAKE ELMO
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State | MN
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Zip | 55042-9607
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Country | US
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Telephone | 763-237-4229
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Fax |
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Provider Business Mailing Address
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Address Line | 4350 WADSWORTH BLVD STE 200
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-4634
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Country | US
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Telephone | 763-237-4229
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 30746
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL.0020760
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License Number State | CO
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