Individual
MS. ELIZABETH GALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1003 DIVISION ST, STE 5, PRESCOTT, AZ 86301-1657
(928) 445-7632
(928) 445-9283
Mailing address
3003 N CENTRAL AVENUE, STE 400, AKDHC, LLC, PHOENIX, AZ 85012-0000
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
873988
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218901
—
AZ
01
—
873988
RD LICENSE
AZ
Enumeration date
04/24/2007
Last updated
08/12/2008
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