IVYCREEK OF ELMORE LLC NPI 1366565152

NPI Information

IVYCREEK OF ELMORE LLC is a rural health clinic center in Wetumpka, AL. IVYCREEK OF ELMORE LLC NPI is 1366565152. The provider is registered as an organization entity type.
The provider Is Doing Business As River Region Family Medicine.

The provider's business location address is:

41 CAMBRIDGE CT
WETUMPKA, AL
ZIP 36093-261
Phone: (334) 567-3309
Fax: (334) 567-3361

The provider's authorized official is Michael D Bruce .
The authorized official title is Ceo and has the following contact phone number (334) 567-4311.

The enumeration date for this NPI number is 4/9/2007 and was last updated on 10/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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