KELLY AMBROSIUS

WADSWORTH, IL
NPI1932322815
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: IL  238.00009)
Enumeration Date2007-04-10
Last Update Date2015-04-01
Business Address
-- KELLY AMBROSIUS CST,CFA,RSA
39067 N CAROLINE AVE #362
WADSWORTH, IL 60083-7728
Phone number: 800-560-8374
Mailing Address
-- KELLY AMBROSIUS CST,CFA,RSA
PO BOX 362
WADSWORTH, IL 60083-0362
Phone number: