An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical Specialty |
261QM2500X |
| NPI # | 1437349131 |
| LBN Legal business name | PROACTIVE PHYSICAL MEDICINE, LLC |
| Authorized official | AILEEN QUELL - (BILLING MANAGER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/29/2007 |
| Last updated | 09/01/2009 - About 17 years ago |
| Identifiers | n/a |
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