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General NPI Number Information
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NPI Number | 1194921841
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Entity Type | Individual
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Provider Name | ELIZABETH GALLOWAY PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 13555 W MCDOWELL RD SUITE 104
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City | GOODYEAR
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State | AZ
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Zip | 85395-2624
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Country | US
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Telephone | 623-932-9636
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Fax | 623-932-9643
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Provider Business Mailing Address
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Address Line | 3601 E MCDOWELL RD APT 1020
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City | PHOENIX
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State | AZ
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Zip | 85008-4366
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Country | US
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Telephone | 602-291-3339
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Fax | 623-932-9643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3637
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License Number State | AZ
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