Individual
TREVOR TODD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
320 RIVER PARK DR STE 245, PROVO, UT 84604-6065
(801) 800-8508
Mailing address
320 RIVER PARK DR STE 245, PROVO, UT 84604-6065
(801) 800-8508
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12296775-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12296775-9934
UTAH DOPL
UT
Enumeration date
05/27/2021
Last updated
01/18/2024
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