Individual
JAMES WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15055 HALL RD, SHELBY TOWNSHIP, MI 48315-6206
(586) 566-0420
(586) 566-4165
Mailing address
15055 HALL RD, UTICA, MI 48315
(586) 566-0420
(586) 566-1465
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
5302024859
MI
Other
Enumeration date
05/12/2014
Last updated
05/12/2014
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