Individual
AMY M AMBROSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
190 E BANNOCK ST, BOISE, ID 83712
(208) 947-7700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA930
ID
Other
Enumeration date
10/12/2011
Last updated
09/11/2012
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