Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Maynard Villavicencio Utayde, PT

Individual provider Physical Therapist · NPI 1699832113

Mr. Maynard Villavicencio Utayde, PT is a Physical Therapist in Mishawaka, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2007
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1409 E Day Rd
Mishawaka, IN 46545-3671
Phone: (574) 257-9880
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 05005198A (IN)

Record details

NPI number1699832113
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedJanuary 3, 2007
Last updated in NPPESJuly 17, 2016

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