Individual
ELISE W BALLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
275 E RIVULON BLVD STE 201, GILBERT, AZ 85297-0008
(602) 734-5664
(480) 401-3844
Mailing address
275 E RIVULON BLVD STE 201, GILBERT, AZ 85297-0008
(602) 734-5664
(480) 401-3844
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5902
AZ
Other
Enumeration date
12/01/2014
Last updated
04/10/2018
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