Provider Demographics
NPI:1508006727
Name:LYNN, REBECCA R (MPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:R
Last Name:LYNN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:R
Other - Last Name:FELTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1130 QUICK RABBIT LOOP
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-9102
Mailing Address - Country:US
Mailing Address - Phone:336-409-4895
Mailing Address - Fax:
Practice Address - Street 1:1130 QUICK RABBIT LOOP
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-9102
Practice Address - Country:US
Practice Address - Phone:336-409-4895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist