NPI | 1154036713 |
---|---|
Doing Business As | PROACTIVE MD - BRAKEBUSH HEALTH CENTER - MOCKSVILLE |
Entity Type | Organization |
Authorized Contact | JAN MARIA HOPKINS Ops Mgr 864-501-0751 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2023-01-18 |
Last Update Date | 2023-01-18 |