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1548883960
PROACTIVE MD KY PSC
LOUISVILLE, KY
NPI
1548883960
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Entity Type
Organization
Authorized Contact
BEN STONER
EVP Finance & Administration
864-501-0815
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2020-05-20
Last Update Date
2024-11-22
Business Address
PROACTIVE MD KY PSC
4340 CRITTENDEN DR
LOUISVILLE, KY 40209-1600
Phone number: 864-501-0751
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Mailing Address
PROACTIVE MD KY PSC
124 ALLAWOOD CT
SIMPSONVILLE, SC 29681-6207
Phone number: 864-501-0751
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