Organization
PROACTIVE MSO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALLEN KEMBLE MD (CHIEF MEDICAL OFFICER)
(864) 640-8355
Entity
Organization
Contact information
Practice address
86 VILLA RD STE 100, GREENVILLE, SC 29615-3052
(864) 501-0751
Mailing address
86 VILLA RD STE 100, GREENVILLE, SC 29615-3052
(864) 501-0751
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/05/2021
Last updated
01/27/2026
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