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Organization
TINY CLINIC, PC
Active
Organization
TINY CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLANA JENESE WISE NP (OWNER / AUTHORIZED OFFICER)
(904) 382-8911
Entity
Organization
Contact information
Practice address
112 HEAD AVE, TALLAPOOSA, GA 30176-1219
(904) 382-8911
(470) 329-0422
Mailing address
618 THORNTON RD STE 3-297, LITHIA SPRINGS, GA 30122-1518
(404) 692-3189
(470) 329-0422
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
10/30/2025
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