IndividualActive
Trevor Brackney
NPI 1518658384 · Integrative Medicine Physician · Provo, UT
Provider details
- NPI number
- 1518658384
- Entity type
- Individual
- Primary specialty
- Integrative Medicine PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
- License
- 8180148-8900 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3650 N University Ave Ste 200
Provo, UT 84604-6658
Phone: (801) 375-7100
Approximate (ZIP-level) locationGet directions
Mailing address
3650 N University Ave Ste 200
Provo, UT 84604-6658
Registry dates
- Enumerated
- 2023-05-15
- Last updated
- 2025-06-05
- Certified
- 2025-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.