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General NPI Number Information
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NPI Number | 1265826846
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Entity Type | Organization
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Legal Business Name | TPJC LLC
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 1874 PIEDMONT AVE NE SUITE 375C
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City | ATLANTA
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State | GA
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Zip | 30324-4869
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Country | US
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Telephone | 404-875-3777
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Fax | 404-874-8049
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Provider Business Mailing Address
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Address Line | 1874 PIEDMONT AVE NE SUITE 375C
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City | ATLANTA
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State | GA
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Zip | 30324-4869
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Country | US
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Telephone | 404-875-3777
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Fax | 404-874-8049
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Authorized Official
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Title or Position | MANAGER
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Name | PHILIP CHARLEMAGNE
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Credential |
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Telephone | 404-875-3777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State | GA
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