| NPI | 1154036713 |
|---|---|
| Doing Business As | PROACTIVE MD - BRAKEBUSH HEALTH CENTER - MOCKSVILLE |
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN KEMBLE Cmo 864-640-8355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2026-06-29 |