Ivy Creek Family Care of Enterprise
NPI #1972317741 in Enterprise, Alabama
Provider Information
- NPI Number
- 1972317741
- Entity Type
- Organization
- Organization Name
- Ivy Creek Family Care of Enterprise
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Feb 3, 2025
- Last Updated
- Mar 4, 2025
Practice Location
- Address
- 6582 BOLL WEEVIL CIR STE B
- City
- Enterprise
- State
- Alabama
- ZIP Code
- 36330-9424
- Phone
- (334) 347-2027
Authorized Official
- Name
- JADE LANE
- Title
- CREDENTIALING MANAGER
- Phone
- (334) 567-4311
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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