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1548944762
JORDAN TYLER AMBROSE
WINCHESTER, VA
NPI
1548944762
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WV 002865)
Enumeration Date
2023-06-09
Last Update Date
2023-06-09
Business Address
JORDAN TYLER AMBROSE LPTA
172 COSTELLO DR
WINCHESTER, VA 22602-4306
Phone number: 540-665-4444
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Mailing Address
JORDAN TYLER AMBROSE LPTA
192 DOE RUN RD
INWOOD, WV 25428-4128
Phone number: 304-590-6173
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