# SALE CREEK FAMILY PRACTICE, PLLC

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

## Provider details

- **NPI number:** 1225352164
- **Authorized official:** DANIEL T. BLACK DO (OWNER)
- **Authorized official phone:** (423) 332-1813

## Contact information

- **Practice address:** 108 GRIFFITH ST, SALE CREEK, TN 37373-9715
- **Practice address phone:** (423) 332-1813
- **Practice address fax:** (423) 332-7732
- **Mailing address:** PO BOX 746, CHATTANOOGA, TN 37401-0746
- **Mailing address phone:** (423) 877-2312
- **Mailing address fax:** (423) 877-5855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1671 | TN | Yes |

## Other

- **Enumeration date:** 03/22/2010
- **Last updated:** 03/22/2010