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Individual

ALEXANDRIA LARSEN-HALLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
15333 HUNTERS RIDGE LN, HUNTERTOWN, IN 46748-9814
(260) 425-4870
(260) 458-8694
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02008274A
IN
207Q00000X
Family Medicine Physician
05688
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/29/2021
Last updated
09/02/2025
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