Organization
360 MEDICAL MANAGEMENT
Active
Other names
The Pain Management Clinic of Woodstock
Organization subpart
No
Provider details
NPI number
Authorized official
MYRON MOOREHEAD (MANAGING MEMBER)
(770) 591-8360
Entity
Organization
Contact information
Practice address
200 PARKBROOKE DR, SUITE 200, WOODSTOCK, GA 30189-6331
(770) 591-8360
(770) 591-8364
Mailing address
200 PARKBROOKE DR, SUITE 100, WOODSTOCK, GA 30189-6331
(770) 591-8360
(770) 591-8364
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
058478
GA
Other
Enumeration date
11/10/2008
Last updated
05/01/2009
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