Most Relevant Information
Provider Data
| NPI Number: | 1003232075 |
| Provider Name: | TIMOTHY PATRICK WAGNER RPH |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 2712 |
Most Important Dates
| Enumeration Date: | 03/13/2014 |
| Last Updated: | 03/13/2014 |
Provider Practice Location
402 E MAIN ST
SIDNEY
MT
592704633
Practice Location Phone/Fax
| Phone: | 4064821992 |
| Fax: | 4064825338 |
Provider Mailing Location
402 E MAIN ST
SIDNEY
MT
592704633
Provider Mailing Phone/Fax
| Phone: | 4064821992 |
| Fax: |