Individual
ERIC SHANNON POLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD,DO
Contact information
Practice address
43 MEDICAL LANE, WHITLEY CITY, KY 42653
(606) 376-1535
Mailing address
238 LILY CREEK RESORT RD, JAMESTOWN, KY 42629-7911
(270) 343-4861
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11944
KY
Other
Enumeration date
08/16/2017
Last updated
08/16/2017
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