Individual
MR. MICHAEL ALLEN WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
71 MOUNTAINEER DR, HC 71 BOX 1F, FRANKLIN, WV 26807
(304) 358-3272
(304) 358-3279
Mailing address
71 MOUNTAINEER DR, HC 71 BOX 1F, FRANKLIN, WV 26807
(304) 358-2475
(304) 358-3279
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0005143
WV
Other
Enumeration date
03/17/2011
Last updated
03/25/2011
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