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1407500309
PROACTIVE MD NM, LLC
SANTA FE, NM
NPI
1407500309
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Entity Type
Organization
Authorized Contact
JAN HOPKINS
Assoc. Ops Mgr
864-501-0751
Organization Subpart ?
No
Primary Taxonomy
261QP2300X Clinic/Center Primary Care
Enumeration Date
2022-02-09
Last Update Date
2022-02-09
Business Address
PROACTIVE MD NM, LLC
1100 S SAINT FRANCIS DR STE 1000
SANTA FE, NM 87505-4147
Phone number: 864-501-0751
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Mailing Address
PROACTIVE MD NM, LLC
124 ALLAWOOD CT. ALLAWOOD CT
SIMPSONVILLE, SC 29681
Phone number: 864-501-0751
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