Healthcare Provider Details

I. General information

NPI: 1265350888
Provider Name (Legal Business Name): TRAVERSE PODIATRY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N CENTER ST STE 150
LEHI UT
84043-7501
US

IV. Provider business mailing address

3401 N CENTER ST STE 150
LEHI UT
84043-7501
US

V. Phone/Fax

Practice location:
  • Phone: 563-249-3034
  • Fax:
Mailing address:
  • Phone: 563-249-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: STEVEN CRAIG
Title or Position: SOLE OWNER
Credential:
Phone: 563-249-3034