| Organization Name: | MAYES PHYSICAL THERAPY, INC |
| NPI Number: | 1225235039 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DARYL DEAN MAYES (OWNER) |
| Mailing Address: | 1976 S Lincoln Ave Suite 6a Jerome |
| State: | ID US |
| Postal Code: | 833386150 |
| Phone Number: | 2086441433 |
| Fax Number: | 2086441434 |
| NPI Enumeration Date: | 06/27/2007 |
| NPI Last Update Date: | 05/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |