Proactive Mso, LLC
NPI #1427569367 in Bloomington, Indiana
Provider Information
- NPI Number
- 1427569367
- Entity Type
- Organization
- Organization Name
- Proactive Mso, LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Oct 18, 2017
- Last Updated
- Mar 25, 2022
Practice Location
- Address
- 524 N FAIRVIEW ST
- City
- Bloomington
- State
- Indiana
- ZIP Code
- 47404-3774
- Phone
- (812) 645-1892
Authorized Official
- Name
- JAN HOPKINS
- Title
- ASSOC. OPS MGR
- Phone
- (864) 501-0751
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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