Wagner Industries, Inc.

NPI #1770750010 in Mystic, Connecticut

Provider Information

NPI Number
1770750010
Entity Type
Organization
Organization Name
Wagner Industries, Inc.
Primary Specialty
Optometrist
Enumeration Date
May 15, 2008
Last Updated
May 15, 2008

Practice Location

Address
5 WATER ST
Address 2
C/O OPTIMYSTIC
City
Mystic
ZIP Code
06355-2507
Phone
(860) 536-1313

Authorized Official

Name
DR. THOMAS JEFFREY WAGNER, O.D., M.S.
Title
OWNER/OPTOMETRIST
Phone
(860) 405-5555

Specialties & Taxonomy Codes

Specialty
Optometrist

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