Provider Demographics
NPI:1013162783
Name:EYRAN, CRISTAUF (LMT)
Entity type:Individual
Prefix:
First Name:CRISTAUF
Middle Name:
Last Name:EYRAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5935 CATAWBA WAY
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1558
Mailing Address - Country:US
Mailing Address - Phone:470-292-8421
Mailing Address - Fax:
Practice Address - Street 1:26 W COURT SQ
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-2051
Practice Address - Country:US
Practice Address - Phone:470-705-4213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-23
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT014698225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0220995OtherLABOR AND INDUSTRIES