Individual
MARYELLEN MAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5 N MEADOWS RD, MEDFIELD, MA 02052-2317
(508) 359-9119
(508) 359-9115
Mailing address
372 CHAMBERLAIN ST, HOLLISTON, MA 01746-1529
(508) 429-4787
(508) 429-1698
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT5363
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y66192
BCBS INDIVIDUAL PROVIDER
MA
Enumeration date
08/14/2006
Last updated
07/08/2007
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