# FAMILY MEDICAL CENTER PLLC

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

## Provider details

- **NPI number:** 1972545556
- **Authorized official:** DR. BRYAN L DRAKE D.O. (PARTNER)
- **Authorized official phone:** (208) 414-1124

## Contact information

- **Practice address:** 360 E LIBERTY ST, WEISER, ID 83672-2261
- **Practice address phone:** (208) 414-1124
- **Practice address fax:** (208) 414-0947
- **Mailing address:** 360 E LIBERTY ST, WEISER, ID 83672-2261
- **Mailing address phone:** (208) 414-1124
- **Mailing address fax:** (208) 414-0947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2006
- **Last updated:** 02/27/2008