Individual provider · Type 1 NPI

Mike John Maynard, PTA

Physical Therapy Assistant · San Diego, CA

NPI number 1700901253 Active

Practice location

4655 Ruffner St, Ste. 270
San Diego, CA 92111-2275

Call (800) 787-6787 Map

Mailing address

32 Potomac
Irvine, CA 92620-3254

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X3934 (CA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1700901253

Mike John Maynard, PTA's National Provider Identifier is 1700901253, issued on Mar 20, 2007. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in San Diego, CA. The record was last updated on Jul 8, 2007.