| NPI | 1063058311 |
|---|---|
| Doing Business As | PROACTIVE MD E. PULASKI HEALTH CENTER |
| Doing Business As | PROACTIVE MD |
| Entity Type | Organization |
| Authorized Contact | JAN HOPKINS Assoc. Ops Mgr 864-501-0751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2022-03-25 |