IRVEN ROBERT WAGNER

SANTA ROSA, CA
NPI1376687814
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy152WV0400X Optometrist, Vision Therapy
(Licence: CA  8372TPA)
Enumeration Date2007-02-17
Last Update Date2009-04-22
Business Address
Dr. IRVEN ROBERT WAGNER O.D.
800 CODDINGTOWN CTR
SANTA ROSA, CA 95401-3511
Phone number: 707-526-1881
Mailing Address
Dr. IRVEN ROBERT WAGNER O.D.
1945 PINER RD SPC 118
SANTA ROSA, CA 95403-6911
Phone number: 707-526-1881