# TINY DUCKY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Black Tie Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629888474
- **Authorized official:** DR. JEREMIAS DUARTE DO (PHYSICIAN)
- **Authorized official phone:** (770) 559-3186

## Contact information

- **Practice address:** 2820 LASSITER RD STE 100, BLDG B, MARIETTA, GA 30062-8332
- **Practice address phone:** (770) 559-3186
- **Mailing address:** 2820 LASSITER RD STE 100, BLDG B, MARIETTA, GA 30062-8332
- **Mailing address phone:** (770) 559-3186

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/13/2025
- **Last updated:** 01/13/2025