Provider Demographics
NPI:1386972743
Name:MAYFIELD, MECHELLE NICOLE (PT)
Entity type:Individual
Prefix:MRS
First Name:MECHELLE
Middle Name:NICOLE
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:MECHELLE
Other - Middle Name:NICOLE
Other - Last Name:CURD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1076 W CHANDLER BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5223
Mailing Address - Country:US
Mailing Address - Phone:480-821-1997
Mailing Address - Fax:480-821-2536
Practice Address - Street 1:6262 VETERANS PARKWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31908
Practice Address - Country:US
Practice Address - Phone:706-494-3071
Practice Address - Fax:706-494-3201
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23433225100000X
OK4263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist