Individual
MALLORY A GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2024 DORCHESTER CT STE 1, GOSHEN, IN 46526-6546
(574) 537-8326
(574) 534-1034
Mailing address
2024 DORCHESTER CT STE 1, GOSHEN, IN 46526-6546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005825A
IN
Other
Enumeration date
05/07/2015
Last updated
03/18/2024
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