Provider Demographics
NPI:1629439302
Name:GALLER, ELIZABETH (PA)
Entity Type:Individual
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First Name:ELIZABETH
Middle Name:
Last Name:GALLER
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Gender:F
Credentials:PA
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:866-630-9882
Mailing Address - Fax:920-682-5810
Practice Address - Street 1:12855 N 40 DR
Practice Address - Street 2:180
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8657
Practice Address - Country:US
Practice Address - Phone:314-878-5599
Practice Address - Fax:314-392-4290
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2021-09-16
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant