Individual
RICHARD W. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
218 N MAIN ST (US 19), CHIEFLAND, FL 32626
(352) 493-4448
(352) 490-8100
Mailing address
P.O. BOX 2622, CHIEFLAND, FL 32644
(135) 249-3444
(135) 249-0810
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2419
FL
Other
Enumeration date
05/17/2006
Last updated
09/11/2018
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