Provider Demographics
NPI:1639245681
Name:MAYES, JAMES L (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:MAYES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5722 CONSTANTINE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVALE
Mailing Address - State:TN
Mailing Address - Zip Code:37153
Mailing Address - Country:US
Mailing Address - Phone:615-849-5953
Mailing Address - Fax:
Practice Address - Street 1:324 DOOLITTLE RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190
Practice Address - Country:US
Practice Address - Phone:615-563-7252
Practice Address - Fax:615-563-7318
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN3004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist