Organization
MAXX LIFE HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA WALLER (MANAGING MEMBER)
(404) 932-7183
Entity
Organization
Contact information
Practice address
1540 PENNSYLVANIA AVE STE B, MCDONOUGH, GA 30253-9112
(404) 932-7183
Mailing address
1540 PENNSYLVANIA AVE STE B, MCDONOUGH, GA 30253-9112
(404) 932-7183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
11/14/2022
Last updated
12/22/2023
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