Provider Demographics
NPI:1689274318
Name:MPATH, LLC
Entity Type:Organization
Organization Name:MPATH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / AUTHORIZED REP
Authorized Official - Prefix:
Authorized Official - First Name:INGERLISA
Authorized Official - Middle Name:WENCHE
Authorized Official - Last Name:MATTOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-818-6788
Mailing Address - Street 1:PO BOX 7268
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-0268
Mailing Address - Country:US
Mailing Address - Phone:970-663-2742
Mailing Address - Fax:970-342-2093
Practice Address - Street 1:6215 AVIATION CIR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9293
Practice Address - Country:US
Practice Address - Phone:970-818-6788
Practice Address - Fax:970-669-0159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty