Proactive Mso, LLC
NPI #1972011815 in Terre Haute, Indiana
Provider Information
- NPI Number
- 1972011815
- Entity Type
- Organization
- Organization Name
- Proactive Mso, LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Jan 12, 2018
- Last Updated
- Mar 25, 2022
Practice Location
- Address
- 3495 S 4TH ST
- City
- Terre Haute
- State
- Indiana
- ZIP Code
- 47802-5501
- Phone
- (812) 220-4755
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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