# TOOELE CLINIC CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487656781
- **Authorized official:** MR. MICHAELE PORTACCI (SENIOR GROUP VP)
- **Authorized official phone:** (615) 309-3340

## Contact information

- **Practice address:** 330 FRANKLIN RD \#135A-304, BRENTWOOD, TN 37027-3280
- **Practice address phone:** (615) 309-3338
- **Mailing address:** 330 FRANKLIN RD, BRENTWOOD, TN 37027-3280
- **Mailing address phone:** (615) 309-3338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 87063588 | UT | Yes |

## Other

- **Enumeration date:** 06/01/2005
- **Last updated:** 08/22/2020