Healthcare Provider Details
I. General information
NPI: 1518883644
Provider Name (Legal Business Name): TRAVERSE PODIATRY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3401 N CENTER ST
LEHI UT
84043-7497
US
IV. Provider business mailing address
7208 S VIANSA CT
MIDVALE UT
84047-5681
US
V. Phone/Fax
- Phone: 563-249-3034
- Fax:
- Phone: 563-249-3034
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
EDWARD
CRAIG
Title or Position: OWNER
Credential: DPM
Phone: 563-249-3034