Provider Demographics
NPI:1730970039
Name:MAYES, DIANE RENAE (DPT)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:RENAE
Last Name:MAYES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9125 SHELBY 364
Mailing Address - Street 2:
Mailing Address - City:HUNNEWELL
Mailing Address - State:MO
Mailing Address - Zip Code:63443-3013
Mailing Address - Country:US
Mailing Address - Phone:573-470-3681
Mailing Address - Fax:
Practice Address - Street 1:2001 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1902
Practice Address - Country:US
Practice Address - Phone:317-338-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist