OrganizationActive
Ivy Creek of Tallapoosa LLC
NPI 1932130002 · Rural Health Clinic/Center · Dadeville, AL
Provider details
- NPI number
- 1932130002
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Bruce, Ceo(334) 567-4311
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
301 Mariarden Rd
Dadeville, AL 36853-0129
Phone: (256) 825-7871
Fax: (256) 825-5742
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 129
Dadeville, AL 36853-0129
Other names (DBA / former)
- Doing business as
- Lake Martin Family Medicine
- Doing business as
- Lake Martin Family Medicine
Registry dates
- Enumerated
- 2006-07-06
- Last updated
- 2022-04-05
- Certified
- 2022-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.