Individual
GREG WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1310 MAIN ST, WOODWARD, OK 73801-3002
(580) 256-6600
(580) 254-2835
Mailing address
1310 MAIN ST, WOODWARD, OK 73801-3002
(580) 256-6600
(580) 254-2835
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12055
OK
Other
Enumeration date
06/15/2019
Last updated
06/15/2019
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