Individual
MISS ELISSA MICHELLE POILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
230 ROWE RD, WHEELER, OR 97147-0035
(844) 715-2999
(844) 715-3299
Mailing address
10431 BLACKWELL RD, CENTRAL POINT, OR 97502-9658
(541) 613-7632
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0002057
OR
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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