| NPI | 1952589046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS MERLE WAGNER O PT Ometrist 407-894-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC001701) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-02-21 |