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Individual

AMBRUSS PETERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L, CLT

Contact information

Practice address
1002 FOREST DR, RIVERTON, WY 82501-2918
(307) 856-9471
Mailing address
PO BOX 392, SHOSHONI, WY 82649-0392
(307) 876-2284

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
626
WY

Other

Enumeration date
06/30/2008
Last updated
06/30/2008
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