| NPI | 1821535287 | 
|---|---|
| Other Name | PROACTIVE MD | 
| Doing Business As | PROACTIVE MD TIPPECANOE COUNTY GOVT. 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 | 2017-01-24 | 
| Last Update Date | 2022-03-25 |