Individual
VON POLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
(208) 359-2101
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
03/06/2012
Last updated
05/29/2025
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