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1912202334
BRENT ELROY POULTON
MEDFORD, OR
NPI
1912202334
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2011-01-14
Last Update Date
2011-01-14
Business Address
Mr. BRENT ELROY POULTON MS
1002 S OAKDALE AVE
MEDFORD, OR 97501-3536
Phone number: 541-857-8949
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Mailing Address
Mr. BRENT ELROY POULTON MS
1005 E MAIN ST
MEDFORD, OR 97504-7448
Phone number:
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