Individual
KRIS ADWARDS VANWAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
49 LAWRENCE AVE, POTSDAM, NY 13676-1889
(315) 274-9085
(315) 274-9084
Mailing address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 274-9085
(315) 274-9084
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
246425
NY
Other
Enumeration date
10/22/2007
Last updated
12/17/2012
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