Provider Demographics
NPI:1457751497
Name:HYNICK, REBEKAH CASEY
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:CASEY
Last Name:HYNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 WOOD THRUSH WAY
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-5335
Mailing Address - Country:US
Mailing Address - Phone:316-258-7196
Mailing Address - Fax:888-676-9709
Practice Address - Street 1:211 WOOD THRUSH WAY
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-5335
Practice Address - Country:US
Practice Address - Phone:316-258-7196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist