Healthcare Provider Details

I. General information

NPI: 1669097580
Provider Name (Legal Business Name): AUGUST RIVERS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 FRANCIS ST
LONGMONT CO
80501-5308
US

IV. Provider business mailing address

125 3RD ST
FORT COLLINS CO
80524-2514
US

V. Phone/Fax

Practice location:
  • Phone: 720-656-2881
  • Fax:
Mailing address:
  • Phone: 720-815-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0022505
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: