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Individual

MR. TRAVIS ANTHONY PETERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA, MFA

Contact information

Practice address
3305 W MAYFLOWER WAY STE 4, LEHI, UT 84048-2961
(833) 208-9009
(866) 680-1322
Mailing address
3305 W MAYFLOWER WAY STE 4, LEHI, UT 84048-2961
(833) 208-9009
(866) 680-1322

Taxonomy

Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary

Other

Enumeration date
04/22/2024
Last updated
08/26/2025
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