Organization
MY CHRONIC CARE MANAGEMENT
Active
Organization
MY CHRONIC CARE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE L WOODARD (PRESIDENT)
(404) 309-5200
Entity
Organization
Contact information
Practice address
20 WHITLOCK PL SW STE 101, MARIETTA, GA 30064-3176
(770) 635-7166
(404) 591-8002
Mailing address
PO BOX 2198, KENNESAW, GA 30156-9102
(770) 635-7166
(404) 591-8002
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
05/20/2020
Last updated
10/20/2020
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