Individual
MR. BRENT ELROY POULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1002 S OAKDALE AVE, MEDFORD, OR 97501-3536
(541) 857-8949
Mailing address
1005 E MAIN ST, MEDFORD, OR 97504-7448
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/14/2011
Last updated
01/14/2011
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