Individual
RYAN DAVID AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
10750 W MCDOWELL RD, BLDG A100, AVONDALE, AZ 85392-5960
(623) 877-3007
Mailing address
6761 E KELTON LN, SCOTTSDALE, AZ 85254-5645
(262) 295-5154
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2112
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2112
ARIZONA OPTOMETRIC LICENSING NUMBER
AZ
Enumeration date
06/20/2016
Last updated
06/26/2024
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