Individual
MR. GLEN AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1408 E FRANKLIN ST, MONROE, NC 28112-5160
(704) 283-6040
Mailing address
1408 E FRANKLIN ST, MONROE, NC 28112-5160
(704) 283-6040
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
49265
NC
Other
Enumeration date
02/27/2014
Last updated
02/27/2014
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