Individual
MALLORY MANKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4903 S EMERSON AVE, INDIANAPOLIS, IN 46203-5938
(317) 352-5582
Mailing address
6590 LAKE FOREST DR, AVON, IN 46123-7405
(317) 373-6392
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/20/2022
Last updated
12/20/2022
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