Organization
PETERSVILLE FAMILY CARE, LLC
Active
Other names
Petersville Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN DENISE MILLER CRNP (OWNER)
(256) 275-7125
Entity
Organization
Contact information
Practice address
2929 CLOVERDALE RD, FLORENCE, AL 35633
(256) 366-3551
Mailing address
2929 CLOVERDALE RD UNIT D, FLORENCE, AL 35633-1505
(256) 275-7125
(256) 275-7254
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1-01128
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265837769
INDIVIDUAL NPI
AL
Enumeration date
04/16/2018
Last updated
05/03/2024
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