| NPI | 1760678155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW O LEAVITT Physician 801-225-5409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: UT 65908671205) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: UT 65908671205) |
| 207ZD0900X Pathology Dermatopathology (Licence: UT 65908671205) | |
| 207ZI0100X Pathology Immunopathology (Licence: UT 65908671205) | |
| 207ZN0500X Pathology Neuropathology (Licence: UT 65908671205) | |
| 207ZP0007X Pathology Molecular Genetic Pathology (Licence: UT 65908671205) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: UT 65908671205) | |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2008-06-10 |