Organization
RICHARD WAGNER , OD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD WAGNER OD (OPTOMETRY)
(352) 493-4448
Entity
Organization
Contact information
Practice address
218 N MAIN ST, 218 N MAIN ST, CHIEFLAND, FL 32626-0802
(352) 493-4448
(352) 490-8100
Mailing address
218 N MAIN ST, P.O. BOX 2622, CHIEFLAND, FL 32626-0802
(352) 493-4448
(352) 490-8100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13825
FL
Other
Enumeration date
04/16/2007
Last updated
09/26/2007
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