Healthcare Provider Details

I. General information

NPI: 1760940571
Provider Name (Legal Business Name): TLK PHOTOGRAPHY,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2019
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 PERIMETER CTR N STE 300
ATLANTA GA
30346-3401
US

IV. Provider business mailing address

3887 HARTS MILL LN NE
BROOKHAVEN GA
30319-1813
US

V. Phone/Fax

Practice location:
  • Phone: 404-422-5553
  • Fax:
Mailing address:
  • Phone: 404-487-0581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: MRS. TURNER KRUEGER
Title or Position: OWNER
Credential:
Phone: 404-487-0581