Organization
PROACTIVE MSO, LLC
Active
Other names
Clinton Central Satellite Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ABBY ROBB RUSSELL (DIRECTOR OF IMPLEMENTATIONS)
(864) 900-5687
Entity
Organization
Contact information
Practice address
725 N STATE ROAD 29, MICHIGANTOWN, IN 46057-9615
(864) 501-0751
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
12/04/2023
Last updated
12/04/2023
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