Individual
GARRISON SCOTT WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
817 MAIN ST, BENTON, KY 42025-1240
(270) 527-9374
Mailing address
817 MAIN ST, BENTON, KY 42025-1240
(127) 052-7937
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
022065
KY
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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