Provider Demographics
NPI:1841698289
Name:PROACTIVE OCCUPATIONAL MEDICINE, INC.
Entity type:Organization
Organization Name:PROACTIVE OCCUPATIONAL MEDICINE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-574-1770
Mailing Address - Street 1:1661 STATE ROUTE 522
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-8120
Mailing Address - Country:US
Mailing Address - Phone:740-574-1770
Mailing Address - Fax:740-574-8781
Practice Address - Street 1:1661 STATE ROUTE 522
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-8120
Practice Address - Country:US
Practice Address - Phone:740-574-8728
Practice Address - Fax:740-574-8918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine