NPI | 1316710742 |
---|---|
Doing Business As | PROACTIVE MD |
Entity Type | Organization |
Authorized Contact | JODY ADDAIR Clinical Ops Project Coord. 864-501-0751 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2023-11-07 |
Last Update Date | 2024-09-26 |