Organization
PROACTIVE MD OH LLC
Active
Other names
Proactive MD-VEGA Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KEMBLE MD (CMO)
(864) 501-0751
Entity
Organization
Contact information
Practice address
3877 MASON RESEARCH PKWY, MASON, OH 45036-9435
(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
11/07/2023
Last updated
04/03/2025
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