Individual
HEATHER NICOLE AMBROSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1000 CORPORATE CENTER DR STE 100, MORROW, GA 30260-4106
(770) 968-8888
(770) 960-2473
Mailing address
1000 CORPORATE CENTER DR STE 100, MORROW, GA 30260-4106
(770) 968-8888
(770) 960-2473
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 002719
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003128849A
—
GA
Enumeration date
08/13/2012
Last updated
09/26/2016
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