| NPI | 1316710742 |
|---|---|
| Doing Business As | PROACTIVE MD |
| Entity Type | Organization |
| Authorized Contact | DARIA JONES Operations Project Coordinator 864-501-0751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2023-11-07 |