Individual
AUSTIN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
12509 DORSETT RD, MARYLAND HEIGHTS, MO 63043-3909
(314) 434-4224
Mailing address
12509 DORSETT RD, MARYLAND HEIGHTS, MO 63043-3909
(314) 434-4224
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2021041618
MO
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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