Ivy Creek Of Tallapoosa, Llc | |
5958 Highway 49 S Unit K Dadeville AL 36853-6771 | |
(256) 825-7871 | |
Not Available |
Full Name | Ivy Creek Of Tallapoosa, Llc |
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Speciality | Clinic/center - Primary Care |
Location | 5958 Highway 49 S Unit K, Dadeville, Alabama |
Authorized Official Name and Position | Michael D Bruce (CEO / OWNER) |
Authorized Official Contact | 3345674311 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ivy Creek Of Tallapoosa, Llc 5958 Highway 49 S Unit K Dadeville AL 36853-6771 Ph: () - | Ivy Creek Of Tallapoosa, Llc 5958 Highway 49 S Unit K Dadeville AL 36853-6771 Ph: (256) 825-7871 |
NPI Number | 1427773936 |
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Provider Enumeration Date | 10/06/2022 |
Last Update Date | 10/06/2022 |
Identifier | Type | State | Issuer |
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1427773936 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |