Individual
MICHAEL PAUL WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6941 SOUTHDALE RD, EDINA, MN 55435-1648
(952) 250-1640
Mailing address
6941 SOUTHDALE RD, EDINA, MN 55435-1648
(952) 250-1640
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113353
MN
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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