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Individual

TIMOTHY PATRICK WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
402 E MAIN ST, SIDNEY, MT 59270-4633
(406) 482-1992
(406) 482-5338
Mailing address
402 E MAIN ST, SIDNEY, MT 59270-4633
(406) 482-1992

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2712
MT

Other

Enumeration date
03/13/2014
Last updated
03/13/2014
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