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General NPI Number Information
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NPI Number | 1124469226
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Entity Type | Organization
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Legal Business Name | AMBROSIA HEALING ARTS, INC.
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 1519 9TH ST SUITE 103
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City | MARYSVILLE
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State | WA
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Zip | 98270-4600
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Country | US
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Telephone | 360-653-2526
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Fax | 360-363-6699
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Provider Business Mailing Address
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Address Line | 1519 9TH ST SUITE 103
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City | MARYSVILLE
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State | WA
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Zip | 98270-4600
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Country | US
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Telephone | 360-653-2526
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Fax | 360-363-6699
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JOSEPH EMRYS
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Credential | L.AC., EAMP
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Telephone | 828-680-9524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 60343617
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License Number State | WA
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