Individual
DR. DAVID A WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3285 STATE ROUTE 257, SENECA, PA 16346-2529
(814) 677-6636
(814) 677-9562
Mailing address
3285 STATE ROUTE 257, PO BOX 307, SENECA, PA 16346-2529
(814) 677-6636
(814) 677-9562
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000125
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG000125
PA
152WL0500X
Low Vision Rehabilitation Optometrist
OEG000125
PA
152WP0200X
Pediatric Optometrist
OEG000125
PA
152WV0400X
Vision Therapy Optometrist
OEG000125
PA
152WX0102X
Occupational Vision Optometrist
OEG000125
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018040170003
—
PA
Enumeration date
07/18/2006
Last updated
07/25/2012
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