NPI | 1336611201 |
---|---|
Other Name | PROACTIVE MD |
Doing Business As | PROACTIVE MD TSC LSC HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | JAN HOPKINS Assoc. Ops Mrg 864-501-0751 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2018-12-17 |
Last Update Date | 2022-07-26 |