Individual
MR. JEFFREY RYAN AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1519 S BOSTON AVE, TULSA, OK 74119-4015
(918) 712-7805
Mailing address
459 STARLING CT APT 102, WADSWORTH, OH 44281-7926
(330) 907-3517
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1700
ME
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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