Individual
WADE FRECKER AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
125 CITY POINT RD, BELFAST, ME 04915-7330
(207) 338-9999
Mailing address
125 CITY POINT RD, BELFAST, ME 04915-7330
(207) 338-9999
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA2353
ME
Other
Enumeration date
11/21/2010
Last updated
06/03/2015
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