Organization
PROACTIVE MSO, LLC
Active
Other names
Monroe County Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JODY B ADDAIR (CLINICAL OPS PROJECT COORDINATOR)
(317) 556-0017
Entity
Organization
Contact information
Practice address
501 N MORTON ST STE 109, BLOOMINGTON, IN 47404-3732
(864) 501-0751
(864) 990-3834
Mailing address
124 ALLAWOOD CT, SIMPSONVILLE, SC 29681-6207
(864) 501-0751
(864) 990-3834
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2024
Last updated
09/23/2025
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