Provider Demographics
NPI:1629475967
Name:QUAIFE, AUGUST CAPRI (MOTR/L, LMT)
Entity Type:Individual
Prefix:
First Name:AUGUST
Middle Name:CAPRI
Last Name:QUAIFE
Suffix:
Gender:F
Credentials:MOTR/L, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-0363
Mailing Address - Country:US
Mailing Address - Phone:800-472-9515
Mailing Address - Fax:801-447-0107
Practice Address - Street 1:12453 S 265 W STE B
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5420
Practice Address - Country:US
Practice Address - Phone:801-443-7775
Practice Address - Fax:801-447-0107
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5044485-4701225700000X
UT5044485-4201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist