Individual
EARL AMBROZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1111 FENNIMORE ST, FAIRMONT, WV 26554-1538
(304) 365-2322
Mailing address
1111 FENNIMORE ST, FAIRMONT, WV 26554-1538
(304) 365-2322
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001884
WV
Other
Enumeration date
11/30/2022
Last updated
11/30/2022
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