Individual
MARANDA J AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
502 N 9TH AVE, VINTON, IA 52349-2254
(319) 472-6200
Mailing address
103 WILSON ST, DYSART, IA 52224-9652
(319) 594-4186
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005118
IA
Other
Enumeration date
01/03/2021
Last updated
01/03/2021
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