Organization
PROACTIVE MSO, LLC
Active
Other names
Proactive MD, Proactive MD TSC LSC Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAN HOPKINS (ASSOC. OPS MRG)
(864) 501-0751
Entity
Organization
Contact information
Practice address
4900 OLD US HIGHWAY 231 S, LAFAYETTE, IN 47909-2470
(765) 772-7098
Mailing address
124 ALLAWOOD CT, SIMPSONVILLE, SC 29681-6207
(864) 501-0751
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
07/26/2022
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