Provider Demographics
NPI:1710546734
Name:HYNSON, MICHAEL WOLODYMYR
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WOLODYMYR
Last Name:HYNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9171 BALTIMORE NATIONAL PIKE STE 120
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3946
Mailing Address - Country:US
Mailing Address - Phone:410-480-3705
Mailing Address - Fax:410-480-3707
Practice Address - Street 1:90 SOUTHSIDE AVE STE 225
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4188
Practice Address - Country:US
Practice Address - Phone:828-254-3525
Practice Address - Fax:828-254-0792
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27524225100000X
NCP21626225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist