Individual
LACEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
2700 W 10TH ST, SIOUX FALLS, SD 57104-2547
(605) 271-1645
(605) 271-0802
Mailing address
2700 W 10TH ST, SIOUX FALLS, SD 57104-2547
(605) 271-1645
(605) 271-0802
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5750
SD
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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