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Organization

ALFRED A. WAGNER

Active
Other names
Alfred A. Wagner, O.D.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALFRED A. WAGNER O.D. (DOCTOR OF OPTO (OWNER/OPTOMETRIST)
(607) 625-2121
Entity
Organization

Contact information

Practice address
8740 STATE ROUTE 434, APALACHIN, NY 13732-4009
(607) 625-2121
(607) 625-2131
Mailing address
P.O. BOX 315, APALACHIN, NY 13732-4009
(607) 625-2121
(607) 625-2131

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV003310-1
NY

Other

Enumeration date
11/22/2013
Last updated
11/22/2013
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