| Doctor Name: | MARYELLEN MAYNES |
| NPI Number: | 1427061274 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT5363 |
| Business Practice Address: | 5 N Meadows Rd Medfield, MA - 020522317 |
| Business Phone Number: | 5083599119 |
| Business Fax Number: | 5083599115 |
| Mailing Address: | 372 Chamberlain St, HOLLISTON |
| State: | MA |
| Postal Code: | 017461529 |
| Phone Number: | 5084294787 |
| Fax Number: | 5084291698 |
| NPI Enumeration Date: | 08/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT5363 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |