| NPI | 1508480633 |
|---|---|
| Doing Business As | IVY CREEK FAMILY CARE OF WETUMPKA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL D BRUCE CEO 334-567-4311 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-04 |