Provider Demographics
NPI:1538312632
Name:SAMPEY, ELIZABETH ROSE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ROSE
Last Name:SAMPEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:ROSE
Other - Last Name:SONNENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84326-0005
Mailing Address - Country:US
Mailing Address - Phone:435-232-4279
Mailing Address - Fax:888-668-5207
Practice Address - Street 1:5400 WARD RD
Practice Address - Street 2:BLDG 1, SUITE 100
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1819
Practice Address - Country:US
Practice Address - Phone:303-432-2112
Practice Address - Fax:303-432-2844
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL-10207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85922781Medicaid
COC305116Medicare PIN