| Proactive Mso, Llc | |
|
715 School Dr Winamac IN 46996-1584 | |
| (812) 645-1892 | |
| Not Available |
| Full Name | Proactive Mso, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 715 School Dr, Winamac, Indiana |
| Authorized Official Name and Position | Jan Hopkins (ASSOC. OPS MGR) |
| 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 715 School Dr Winamac IN 46996-1584 Ph: (812) 645-1892 |
| NPI Number | 1063058311 |
|---|---|
| Provider Enumeration Date | 11/21/2019 |
| Last Update Date | 03/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063058311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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