Organization
MELADJOY THERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAYNARD VILLAVICENCIO UTAYDE PT (CEO)
(574) 386-7570
Entity
Organization
Contact information
Practice address
54473 WHITE TAIL DR, MISHAWAKA, IN 46545-1849
(574) 386-7555
Mailing address
54473 WHITE TAIL DR, MISHAWAKA, IN 46545-1849
(574) 386-7555
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2007
Last updated
08/22/2020
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