Organization
PROACTIVE MD IA PC
Active
Other names
Proactive MD CF Port Neal Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KEMBLE MD (CMO)
(864) 501-0751
Entity
Organization
Contact information
Practice address
1182 260TH ST, SERGEANT BLUFF, IA 51054-7739
(712) 317-1130
Mailing address
10 CENTIMETERS DR, MAULDIN, SC 29662-3278
(864) 501-0751
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
04/10/2025
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