Individual provider · Type 1 NPI

Mallory Christine Larsen, PA-C

Medical Physician Assistant · Indianapolis, IN

NPI number 1255780656 Active

Practice location

5330 E Stop 11 Rd
Indianapolis, IN 46237-6345

Call (317) 893-1900 Map

Fax (317) 893-1901

Mailing address

PO Box 781076
Detroit, MI 48278-1076

Other practice locations

  • 1402 E County Line Rd, Indianapolis, IN 46227-0963 · (317) 887-7000

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X10002066A (IN)
Medical Physician Assistant 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1255780656

Mallory Christine Larsen, PA-C's National Provider Identifier is 1255780656, issued on Jun 7, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Indianapolis, IN. The record was last updated on May 23, 2023.