Charles John Poth

NPI #1336027507 in Eagan, Minnesota

Provider Information

NPI Number: 1336027507
Entity Type: Individual
Name: Charles John Poth
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Aug 25, 2025
Last Updated: Aug 25, 2025

Practice Location

Address: 4635 NICOLS RD APT 104
City: Eagan
State: Minnesota
ZIP Code: 55122-3337
Phone: (612) 289-6480

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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