Organization
PROACTIVE MSO, LLC
Active
Other names
Proactive MD Monroe Health Center, Proactive MD
Organization subpart
No
Provider details
NPI number
Authorized official
JAN HOPKINS (ASSOC. OPS MGR)
(864) 501-0751
Entity
Organization
Contact information
Practice address
524 N FAIRVIEW ST, BLOOMINGTON, IN 47404-3774
(812) 645-1892
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
10/18/2017
Last updated
03/25/2022
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