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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. TRAVIS ANTHONY PETERSEN, BA, MFA

Active Sole Proprietor

Ocularist · LEHI, UT

Registration Details

NPI Number
1962257949
Provider Type
Individual
Gender
Male
NPI Issued
Apr 22, 2024 (2.0015264635051 yrs)
Last Updated
Aug 26, 2025
Sole Proprietor
Yes

Practice Information

Address
3305 W MAYFLOWER WAY STE 4
LEHI, UT, 840482961
Browse UT providers · Browse ZIP 84048
Phone
8332089009
Fax
8666801322
Primary Specialty
Ocularist
156FX1700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.