Ivy Creek of Tallapoosa, LLC
NPI #1932783693 in Dadeville, Alabama
Provider Information
- NPI Number
- 1932783693
- Entity Type
- Organization
- Organization Name
- Ivy Creek of Tallapoosa, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- IVY CREEK OF TALLAPOOSA, LLC
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- May 10, 2021
- Last Updated
- Apr 5, 2022
Practice Location
Authorized Official
- Name
- MICHAEL D BRUCE, CEO & AO
- Title
- CEO
- Phone
- (334) 567-4311
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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