Individual
DR. BRADLEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-5035
(804) 675-5000
Mailing address
1201 BROAD ROCK BLVD PHARMACY BB-100, RICHMOND, VA 23249-0001
(804) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202212158
VA
Other
Enumeration date
08/17/2023
Last updated
02/14/2024
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