| NPI | 1790223048 |
|---|---|
| Other Name | PROACTIVE MD |
| Doing Business As | PROACTIVE MD DANA LAFAYETTE HEALTH CENTER |
| 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 | 2017-02-07 |
| Last Update Date | 2022-03-25 |