# PROACTIVE WELLNESS,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952737686
- **Authorized official:** DIANE ELIZABETH WALSH L.AC (BUSINESS OWNER)
- **Authorized official phone:** (609) 234-0617

## Contact information

- **Practice address:** 230 N MAPLE AVE, MARLTON, NJ 08053-9400
- **Practice address phone:** (856) 983-5422
- **Mailing address:** 10 HASTINGS CT, MARLTON, NJ 08053-5332
- **Mailing address phone:** (609) 234-0617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 25MZ00089700 | NJ | Yes |

## Other

- **Enumeration date:** 09/26/2013
- **Last updated:** 10/02/2013