| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1912624883 | PROACTIVE MSO, LLC | 124 ALLAWOOD CT | SIMPSONVILLE | SC | 296816207 | |||
| 1295279958 | KOOISTRA | MILLIE | 110 CRAWFORD ST | TERRE HAUTE | IN | 478074614 | ||
| 1821397688 | MCKANNA | KATHERINE | ROSE | 110 CRAWFORD ST | TERRE HAUTE | IN | 47807 |