Organization
PROACTIVE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN HART NP (DIRECTOR)
(541) 389-8714
Entity
Organization
Contact information
Practice address
62968 O B RILEY RD, #16, BEND, OR 97703-9442
(541) 389-8714
Mailing address
62968 O B RILEY RD, E2-16, BEND, OR 97703-9442
(541) 389-8714
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
000029202N1,,N2,N6
OR
Other
Enumeration date
09/26/2007
Last updated
11/16/2016
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