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1780125310
GARY LEE AMBROSE
SIOUX FALLS, SD
NPI
1780125310
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: SD 7589)
Enumeration Date
2017-03-15
Last Update Date
2017-03-15
Business Address
-- GARY LEE AMBROSE
2412 S CLIFF AVE
SIOUX FALLS, SD 57105-4031
Phone number: 605-322-4079
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Mailing Address
-- GARY LEE AMBROSE
2412 S CLIFF AVE
SIOUX FALLS, SD 57105-4031
Phone number: 605-322-4079
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