Black Hills Family Practice Clinic Ps

NPI #1467542399 in Mccleary, Washington

Provider Information

NPI Number: 1467542399
Entity Type: Organization
Organization Name: Black Hills Family Practice Clinic Ps
Primary Specialty: Family Medicine
Enumeration Date: Oct 13, 2006
Last Updated: Oct 13, 2014

Practice Location

Address: 332 S BIRCH ST
City: Mccleary
State: Washington
ZIP Code: 98557-9522
Phone: (360) 495-3475

Authorized Official

Name: DR. EDWARD R MACKE, MD
Title: PRESIDENT
Phone: (360) 495-3475

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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