Individual
OMAR JERAS ABU-WISHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
157 FONTAINE BLVD, COLORADO SPRINGS, CO 80911-2110
(909) 680-0404
Mailing address
1925 SECLUSION PT, COLORADO SPRINGS, CO 80918-7975
(909) 680-0404
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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