| Proactive Mso, Llc | |
|
13188 S 50 E Kentland IN 47951-8540 | |
| (812) 645-1892 | |
| Not Available |
| Full Name | Proactive Mso, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 13188 S 50 E, Kentland, 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 13188 S 50 E Kentland IN 47951-8540 Ph: (812) 645-1892 |
| NPI Number | 1710525175 |
|---|---|
| Provider Enumeration Date | 12/17/2019 |
| Last Update Date | 03/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710525175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Iroquois Memorial Hospital And Resident Home Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 303 N 7th St, Kentland, IN 47951 Phone: 219-474-5464 Fax: 219-474-3603 |