Individual
MR. ANTONIO STACY AMBROSIO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT,CKTP
Contact information
Practice address
4434 PALISADES WAY, ANTIOCH, CA 94531-9394
(925) 427-4444
Mailing address
4434 PALISADES WAY ANTIOCH,CA 94531, ANTIOCH, CA 94531-9394
(925) 427-4444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13589
CA
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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