Individual
CONRAD ALEXANDER WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
310 N 1ST AVE, IOWA CITY, IA 52245-3617
(319) 351-2921
Mailing address
600 MONTCREW ST, KANSAS CITY, MO 64114-4946
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23957
IA
Other
Enumeration date
08/22/2020
Last updated
08/22/2020
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