Individual
MRS. LARA MITCHELL TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
8402 HARCOURT RD STE 120, INDIANAPOLIS, IN 46260-2006
(317) 338-4303
Mailing address
8402 HARCOURT RD STE 120, INDIANAPOLIS, IN 46260-2006
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10001051
IN
Other
Enumeration date
03/25/2009
Last updated
11/30/2023
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