Organization
PROACTIVE MSO, LLC
Active
Other names
Proactive MD Terre Haute 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
3495 S 4TH ST, TERRE HAUTE, IN 47802-5501
(812) 220-4755
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
01/12/2018
Last updated
03/25/2022
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