Proactive Mso, LLC
NPI #1275371080 in Bloomington, Indiana
Provider Information
- NPI Number
- 1275371080
- Entity Type
- Organization
- Organization Name
- Proactive Mso, LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Jul 16, 2024
- Last Updated
- Sep 23, 2025
Practice Location
- Address
- 501 N MORTON ST STE 109
- City
- Bloomington
- State
- Indiana
- ZIP Code
- 47404-3732
- Phone
- (864) 501-0751
Authorized Official
- Name
- JODY B ADDAIR
- Title
- CLINICAL OPS PROJECT COORDINATOR
- Phone
- (317) 556-0017
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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