Individual
DR. DARYL DEAN MAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T., D.P.T., M.H.S.
Contact information
Practice address
1976 S LINCOLN AVE, SUITE 6A, JEROME, ID 83338-6150
(208) 644-1433
(208) 644-1434
Mailing address
1976 S LINCOLN AVE, SUITE 6A, JEROME, ID 83338-6150
(208) 644-1433
(208) 644-1434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
125
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0044033
—
ID
01
—
1002857
STATE INSURANCE FUND
ID
01
—
1225235039
GROUP NPI
ID
01
—
322212
BLUE SHIELD
ID
01
—
T2797
BLUE CROSS
ID
Enumeration date
01/20/2007
Last updated
07/09/2007
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