Individual
KENNETH JUDSON WAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
117 CHAPMAN ST STE 200, PROVIDENCE, RI 02905-5400
(401) 444-9909
(401) 444-4095
Mailing address
117 CHAPMAN ST STE 200, PROVIDENCE, RI 02905-5400
(401) 444-9909
(401) 444-4095
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
RPH06239
RI
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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