MARC RICHARD LARSEN-HALLOCK

FORT WAYNE, IN
NPI1295362614
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: IN  02008414A)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-03-25
Last Update Date2025-09-02
Business Address
Dr. MARC RICHARD LARSEN-HALLOCK DO
11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845-1673
Phone number: 260-425-6780
Mailing Address
Dr. MARC RICHARD LARSEN-HALLOCK DO
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number: