Organization · Type 2 NPI
Proactive Mso, LLC
Primary Care Clinic/Center · Lafayette, IN
NPI number
1790223048
Active
Practice location
2400 Sagamore Pkwy S
Lafayette, IN 47905-5116
Mailing address
86 Villa Rd Ste 100
Greenville, SC 29615-3052
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
3 other providers at this address
Other primary care clinic/center providers in Lafayette
About NPI 1790223048
Proactive Mso, LLC's National Provider Identifier is 1790223048, issued on Feb 7, 2017. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Lafayette, IN. The record was last updated on Sep 2, 2026.