Basic Information
| Provider Information | |||||||||
| NPI: | 1417157439 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOVEL | ||||||||
| FirstName: | SAMANTHA | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12297 PENNSYLVANIA ST | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | THORNTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802413165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032529400 | ||||||||
| FaxNumber: | 3032559555 | ||||||||
| Practice Location | |||||||||
| Address1: | 12297 PENNSYLVANIA ST | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | THORNTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802413165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032529400 | ||||||||
| FaxNumber: | 3032559555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2007 | ||||||||
| LastUpdateDate: | 04/15/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTL-9663 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.