Dr Wagner Southridge Optical LLC
NPI #1255591236 in Greendale, Wisconsin
Provider Information
- NPI Number
- 1255591236
- Entity Type
- Organization
- Organization Name
- Dr Wagner Southridge Optical LLC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- Jun 12, 2008
- Last Updated
- Aug 17, 2009
Practice Location
Authorized Official
- Name
- MRS. JOAN E SERRANO
- Title
- MANAGER
- Phone
- (414) 855-0469
Specialties & Taxonomy Codes
| Specialty |
|---|
| Eyewear Supplier |
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