Healthcare Provider Details

I. General information

NPI: 1831147982
Provider Name (Legal Business Name): TOOELE VALLEY URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 NO. MAIN ST., STE 201
TOOELE UT
84074
US

IV. Provider business mailing address

1244 N MAIN ST. SUITE 201
TOOELE UT
84074
US

V. Phone/Fax

Practice location:
  • Phone: 435-882-3968
  • Fax: 435-882-3859
Mailing address:
  • Phone: 435-882-3968
  • Fax: 435-882-3859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VALERIE M PRICE
Title or Position: BILLING MANAGER
Credential:
Phone: 435-882-3968