Individual
TARA MARIE MOCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 WISHARD BLVD, INDIANAPOLIS, IN 46202-2872
(317) 274-7447
Mailing address
2324 E ROYAL CT, DES PERES, MO 63131-1941
(314) 358-5874
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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