Individual
FAHARA A MAWANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2403 N 12TH ST, GRAND JUNCTION, CO 81501-8130
(970) 243-8697
(970) 243-8698
Mailing address
2403 N 12TH ST, GRAND JUNCTION, CO 81501-8130
(970) 243-8697
(970) 243-8698
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2571
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
840882401009
ROCKY MNT HEALTH
CO
Enumeration date
03/16/2007
Last updated
10/09/2007
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