Optimystic LLC

NPI #1679107411 in Mystic, Connecticut

Provider Information

NPI Number: 1679107411
Entity Type: Organization
Organization Name: Optimystic LLC
Primary Specialty: Optometrist
Enumeration Date: Mar 2, 2020
Last Updated: Mar 24, 2020

Practice Location

Address: 12 ROOSEVELT AVE
City: Mystic
State: Connecticut
ZIP Code: 06355-2809
Phone: (860) 536-1313

Authorized Official

Name: DR. THOMAS JEFFREY WAGNER, OD
Title: MEMBER
Phone: (860) 536-1313

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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