Individual
MR. MICHAEL SCOTT CHITWOOD SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHP
Contact information
Practice address
1317 3RD AVE, ROCK ISLAND, IL 61201-8562
(309) 794-1230
Mailing address
2200 3RD AVE, ROCK ISLAND, IL 61201-8840
(309) 779-2094
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
XXXXXXX
IA
Other
Enumeration date
03/14/2023
Last updated
09/13/2023
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