Individual
ELISE SAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
HIGHWAY 264 MILEPOST 388, POLACCA, AZ 86042
(928) 737-6000
Mailing address
PO BOX 535, KEAMS CANYON, AZ 86034-0535
(928) 737-6000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN175444
AZ
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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