| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 10/06/2022 |
| Last Update Date | 10/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427773936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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Ivy Creek Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5958 Highway 49 S Unit K, Dadeville, AL 36853 Phone: 256-825-7821 | |
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