ELYSSA BERG

FORT DEFIANCE, AZ
NPI1255745113
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207P00000X Emergency Medicine
(Licence: MI  4301113504)
Enumeration Date2014-06-18
Last Update Date2019-05-24
Business Address
ELYSSA BERG
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504
Phone number: 928-729-8600
Mailing Address
ELYSSA BERG
PO BOX 589
FORT DEFIANCE, AZ 86504-0589
Phone number: 928-792-8600
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