Individual
DR. STEVEN WAGERS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
104 LEGACY DR, BEREA, KY 40403-9594
(859) 986-2323
Mailing address
1820 MALLARD DR, LONDON, KY 40741-9748
(606) 877-3190
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012026
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012026
STATE LICENSE
KY
Enumeration date
10/18/2005
Last updated
07/08/2007
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