Frederick Joseph Wagner Jr., OD
Optometrist in Carlisle, MA. Individual provider (NPI-1).
NPI number1013052257
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1013052257
- Entity type
- Individual (NPI-1)
- Name
- Mr. Frederick Joseph Wagner Jr.
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 21, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2408 | MA | Yes |
Practice location
101 Kimball RdCarlisle, MA 01741
Phone 978-371-2337 · Fax 978-371-2297
Mailing address
101 Kimball RdCarlisle, MA 01741
Phone 978-371-2337 · Fax 978-371-2297
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