Individual
MIRANDA WHITLEY SAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 DRY CREEK DR STE 204, LONGMONT, CO 80503-7748
(303) 938-1141
Mailing address
1325 DRY CREEK DR STE 204, LONGMONT, CO 80503-7748
(303) 938-1141
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTL.0016778
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTL.0016778
COLORADO PHYSICAL THERAPY LICENSE
CO
Enumeration date
01/02/2020
Last updated
04/08/2025
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