Ivy Creek of Elmore, LLC
NPI #1093838880 in Wetumpka, Alabama
Provider Information
- NPI Number
- 1093838880
- Entity Type
- Organization
- Organization Name
- Ivy Creek of Elmore, LLC
- Primary Specialty
- Preferred Provider Organization
- Enumeration Date
- Apr 9, 2007
- Last Updated
- Aug 22, 2020
Practice Location
Authorized Official
- Name
- GORDON FAULK
- Title
- CEO
- Phone
- (334) 567-4311
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
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