Organization
IVY CREEK OF ELMORE, LLC
Active
Parent organization
IVY CREEK OF ELMORE, LLC
Other names
IVY CREEK WOUND CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
IVY CREEK OF ELMORE, LLC
Authorized official
MICHAEL D BRUCE (CEO)
(334) 567-4311
Entity
Organization
Contact information
Practice address
500 HOSPITAL DR STE C, WETUMPKA, AL 36092-1625
(334) 567-4311
(334) 514-3686
Mailing address
PO BOX 130, WETUMPKA, AL 36092-0003
(334) 283-2542
(334) 514-3686
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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