| Proactive Mso, Llc | |
|
3250 Maple Ave Terre Haute IN 47804-1727 | |
| (812) 462-5799 | |
| Not Available |
| Full Name | Proactive Mso, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3250 Maple Ave, Terre Haute, Indiana |
| Authorized Official Name and Position | Jan Maria Hopkins (OPERATIONS MANAGER) |
| Authorized Official Contact | 8645010751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Mso, Llc 124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | Proactive Mso, Llc 3250 Maple Ave Terre Haute IN 47804-1727 Ph: (812) 462-5799 |
| NPI Number | 1457078321 |
|---|---|
| Provider Enumeration Date | 10/21/2022 |
| Last Update Date | 10/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457078321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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