Organization
VALUPATH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW O LEAVITT M.D. (MEMBER)
(801) 225-5407
Entity
Organization
Contact information
Practice address
945 S OREM BLVD, OREM, UT 84058-5011
(801) 225-5407
(801) 225-5623
Mailing address
PO BOX 1442, PROVO, UT 84603-1442
(801) 225-5407
(801) 225-5623
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
65908671205
UT
Other
Enumeration date
05/30/2012
Last updated
10/18/2012
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