Richard W. Wagner OD

NPI 1689626582 - Optometrist - 152WC0802X

NPI Details
NPI 1689626582
Gender Male
Enumeration Date 05/17/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
218 N MAIN ST (US 19)
CHIEFLAND FL, 32626, US
Phone (352) 493-4448
Fax (352) 490-8100
Business Location
P.O. BOX 2622
CHIEFLAND FL, 32644, US
Phone (135) 249-3444
Fax (135) 249-0810
Toxanomy
Taxonomy Code 152WC0802X
License State Florida
License Number 2419
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According to our database, Richard W. Wagner OD NPI is 1689626582, taxonomy code is 152WC0802X and license number is 2419, license state is located at Florida. Richard W. Wagner OD physically located at 218 N Main St (us 19), Chiefland FL, 32626. NPI Number Richard W. Wagner OD has the Individual type.

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1689626582 NPI number is provided on an as is basis without warranty of any kind. 1689626582 is maintained by the National Plan & Provider Enumeration System. The contents of Richard W. Wagner OD are for informational purposes only.