Individual
DR. AMBRA T GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
828 S BROAD ST, SCOTTSBORO, AL 35768-2508
(256) 259-4115
(256) 259-3643
Mailing address
828 S BROAD ST, SCOTTSBORO, AL 35768-2508
(256) 259-4115
(256) 259-3643
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S413TA171
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051513019
—
AL
Enumeration date
10/07/2005
Last updated
05/07/2008
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