Proactive Mso, Llc | |
725 N State Road 29 Michigantown IN 46057-9615 | |
(864) 501-0751 | |
Not Available |
Full Name | Proactive Mso, Llc |
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Speciality | Clinic/center - Primary Care |
Location | 725 N State Road 29, Michigantown, Indiana |
Authorized Official Name and Position | Abby Robb Russell (DIRECTOR OF IMPLEMENTATIONS) |
Authorized Official Contact | 8649005687 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Proactive Mso, Llc 124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | Proactive Mso, Llc 725 N State Road 29 Michigantown IN 46057-9615 Ph: (864) 501-0751 |
NPI Number | 1376319087 |
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Provider Enumeration Date | 12/04/2023 |
Last Update Date | 12/04/2023 |
Identifier | Type | State | Issuer |
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1376319087 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |