Provider Demographics
NPI:1154625846
Name:AMBROSE, JULIAN (RRT)
Entity type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:
Last Name:AMBROSE
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402A VICTORIOUS PL
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-1016
Mailing Address - Country:US
Mailing Address - Phone:252-394-6124
Mailing Address - Fax:
Practice Address - Street 1:736 SUITE E SHAWNEE DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-6146
Practice Address - Country:US
Practice Address - Phone:336-437-7217
Practice Address - Fax:336-226-5437
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-4741227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered