Individual
ETHAN FAHRNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
U1-0002030
DE
Other
Enumeration date
06/20/2019
Last updated
06/29/2020
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