Provider Demographics
NPI:1447585708
Name:AMBROSIA, JULIANNE L (LAC)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:L
Last Name:AMBROSIA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5650 GREENWOOD PLAZA BLVD
Mailing Address - Street 2:STE 135
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2307
Mailing Address - Country:US
Mailing Address - Phone:720-276-7999
Mailing Address - Fax:
Practice Address - Street 1:5650 GREENWOOD PLAZA BLVD
Practice Address - Street 2:STE 135
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2307
Practice Address - Country:US
Practice Address - Phone:720-276-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1499171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist