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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. MAYNARD VILLAVICENCIO UTAYDE, PT

Active Sole Proprietor

MR. MAYNARD VILLAVICENCIO UTAYDE, PT is a Physical Therapy Assistant healthcare provider located in MISHAWAKA, Indiana. NPI 1699832113 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · MISHAWAKA, IN

Registration Details

NPI Number
1699832113
Provider Type
Individual
Gender
Male
NPI Issued
Jan 3, 2007 (19.573699644982 yrs)
Last Updated
Jul 17, 2016
License
05005198A (IN)
Sole Proprietor
Yes

Practice Information

Address
1409 E DAY RD
MISHAWAKA, IN, 465453671
Browse IN providers · Browse ZIP 46545
Phone
5742579880
Primary Specialty
Physical Therapy Assistant
225100000X

Other Physical Therapy Assistant Providers in MISHAWAKA, IN

Name Credential NPI
MR. DAVID YUGO PHYSICAL THERAPIST 1144216979
MRS. JENNIFER CHRISTY-GRIMM P.T. 1447304639
MRS. DAWN R LAPIERRE M.P.T. 1831230028
MANICAR DOMANTAY FERNANDEZ PT 1477750396
MARY L KRAUSE PT 1205036753
MRS. DARLA J LINGLE PT 1144420563
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.