Organization
DR. RYAN AMBROSE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN DAVID AMBROSE OD (OWNER/OPTOMETRIST)
(262) 295-5154
Entity
Organization
Contact information
Practice address
3870 W HAPPY VALLEY RD STE 150, GLENDALE, AZ 85310-3296
(623) 362-8642
(623) 561-1190
Mailing address
6761 E KELTON LN, SCOTTSDALE, AZ 85254-5645
(262) 295-5154
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558711507
INDIVIDUAL NPI
AZ
Enumeration date
06/27/2024
Last updated
06/27/2024
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