MALLORY C BLANKENBERGER PA-C
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1104348044- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA-C
- Status
- Active
Contact & Location
- Address
- 5165 MCCARTY LANE, LAFAYETTE, IN, 479058764
- Phone
- (800) 899-8448
Specialties & Taxonomies
Physician Assistant
Primary License: IN #10002240A
All Addresses
MAILING
250 N SHADELAND AVE
INDIANAPOLIS, IN, 462194959