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Individual

DR. CHARLES WILLIAM FORNARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
224 CHESTNUT STREET, COSHOCTON, OH 43812-1164
(740) 622-1484
(740) 622-1540
Mailing address
224 CHESTNUT STREET, COSHOCTON, OH 43812-1164
(740) 622-1484
(740) 622-1540

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5622
OH
152W00000X
Optometrist
713
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2685018
OH
Enumeration date
11/15/2005
Last updated
10/16/2019
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