Individual
MALLORY BLANCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7510 ROSEGATE DR, INDIANAPOLIS, IN 46237-8301
(317) 889-9300
Mailing address
4638 KINTZ DR, INDIANAPOLIS, IN 46239-9046
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011189A
IN
Other
Enumeration date
03/14/2026
Last updated
03/14/2026
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