Individual
MALLORY CAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 718-4676
Mailing address
2520 DOVER CT, LEBANON, IN 46052-8820
(765) 481-1748
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10003703A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2021
Last updated
03/19/2025
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