| Organization Name: | MAYO PHYSICAL THERAPY LLC |
| NPI Number: | 1417207200 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT KEVIN MAYO (PHYSICAL THERAPIST/OWNER) |
| Mailing Address: | 12023 Highway 84 West Jena |
| State: | LA US |
| Postal Code: | 71342 |
| Phone Number: | 3184450040 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2012 |
| NPI Last Update Date: | 09/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 01246 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |