Individual
ELIZABETH M WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10233 W GREENFIELD AVE, WEST ALLIS, WI 53214-3911
(414) 727-5750
Mailing address
3759 N 88TH ST APT 303, MILWAUKEE, WI 53222-2729
(414) 315-2453
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10404-40
WI
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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