| NPI | 1124180351 |
|---|---|
| Doing Business As | WAGNER EYE CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | RONALD T. WAGNER President 270-651-8323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2010-08-25 |