Individual
ASHLEY CHADWICK DIETERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-1000
Mailing address
6123 STELLA LIGHT DR, FLOWERY BRANCH, GA 30542-3445
(678) 358-0946
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7182
GA
Other
Enumeration date
06/16/2014
Last updated
06/28/2023
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