Organization
PATH PRIME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY OSMOND MD (MANAGER)
(801) 225-5409
Entity
Organization
Contact information
Practice address
945 S OREM BLVD, OREM, UT 84058-5011
(801) 225-5409
(801) 225-5623
Mailing address
945 S OREM BLVD, OREM, UT 84058-5011
(801) 225-5409
(801) 225-5623
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE
—
UT
Enumeration date
02/07/2018
Last updated
02/07/2018
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