Organization · Type 2 NPI
Ivy Creek Prevention Center LLC
General Practice Physician · Dadeville, AL
NPI number
1659755577
Active
Practice location
2129 Moonbrook Dr
Dadeville, AL 36853-5640
Fax (334) 514-3686
Mailing address
PO Box 130
Wetumpka, AL 36092-0003
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1659755577
Ivy Creek Prevention Center LLC's National Provider Identifier is 1659755577, issued on Jul 10, 2015. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Dadeville, AL. The record was last updated on May 19, 2016.