Provider Demographics
NPI:1548783061
Name:UPPONI, ROHAN ASHWIN (AUD)
Entity Type:Individual
Prefix:DR
First Name:ROHAN
Middle Name:ASHWIN
Last Name:UPPONI
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 KNOLLWOOD DR UNIT 2104
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1467
Mailing Address - Country:US
Mailing Address - Phone:903-363-4204
Mailing Address - Fax:
Practice Address - Street 1:2139 N 12TH ST STE 4
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2910
Practice Address - Country:US
Practice Address - Phone:970-546-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO877231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist