Healthcare Provider Details

I. General information

NPI: 1720701725
Provider Name (Legal Business Name): HUMAN TUNE-UP CLINIC, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 ADAMS DR SW
ATLANTA GA
30311-3627
US

IV. Provider business mailing address

PO BOX 54457
ATLANTA GA
30308-0457
US

V. Phone/Fax

Practice location:
  • Phone: 404-640-3023
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ALEM TURPEAU
Title or Position: OWNER
Credential: MD
Phone: 404-640-3023