institution
Ivy Creek Of Elmore Llc
Rural Health Clinic/Center in Wetumpka, Alabama
NPI 1316246812

Ivy Creek Of Elmore Llc is a Rural Health Clinic/Center based in Wetumpka, AL and is specialized in Rural Health. Ivy Creek Of Elmore Llc practices in Wetumpka, AL. The NPI Number for Ivy Creek Of Elmore Llc is 1316246812 and holds a License No. (Alabama).

The current practice location address for Ivy Creek Of Elmore Llc is 815 Jackson Trace Rd, Wetumpka, AL and can be reached out via phone at 334-567-2882 and via fax at 334-567-3361.

Location: 815 Jackson Trace Rd, Wetumpka, AL, 36092-0003
institution
Provider Profile Details
NPI Number
1316246812
Provider Name
Ivy Creek Of Elmore Llc
Credential
Provider Entity Type
Organization
Address
815 Jackson Trace Rd, Wetumpka, AL, 36092-0003
Phone Number
334-567-2882
Fax Number
334-567-3361
Provider Enumeration Date
03/23/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
540003434 05 AL
013434 01 AL MEDICARE
01D0891738 01 AL CLIA
102G701614 01 AL MEDICARE
institution
Provider Business Practice Location Address Details
Address
815 Jackson Trace Rd
City
State
Zip
36092-1504
Phone Number
334-567-2882
Fax Number
334-567-3361
person
Provider Business Mailing Address Details
Address
815 Jackson Trace Rd
City
State
Zip
36092-1504
Phone Number
334-567-2882
Fax Number
334-567-3361
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rural Health
Taxonomy
License No.
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Definition
Definition to come...
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