Individual
LYA CRICHLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1404 RIVER PL STE 201, BRASELTON, GA 30517-5600
(770) 219-9200
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2011-01359
NC
208600000X
Surgery Physician
Primary
91546
GA
Other
Enumeration date
10/16/2009
Last updated
08/03/2022
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