| NPI | 1821535287 |
|---|---|
| Doing Business As | PROACTIVE MD TIPPECANOE COUNTY GOVT. HEALTH CENTER |
| Other Name | PROACTIVE MD |
| Entity Type | Organization |
| Authorized Contact | MARK A KEMBLE Cmo 864-640-8355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2026-09-15 |