Provider Demographics
NPI:1912103524
Name:HUTCHINSON REHAB
Entity Type:Organization
Organization Name:HUTCHINSON REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VANN
Authorized Official - Middle Name:QUINCEY
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:843-464-0697
Mailing Address - Street 1:906 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-4110
Mailing Address - Country:US
Mailing Address - Phone:843-464-0697
Mailing Address - Fax:
Practice Address - Street 1:906 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-4110
Practice Address - Country:US
Practice Address - Phone:843-464-0697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty