Provider Demographics
NPI:1912255688
Name:RHYNE, JEANIE M (PT)
Entity Type:Individual
Prefix:
First Name:JEANIE
Middle Name:M
Last Name:RHYNE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WOODLYN DR
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-6673
Mailing Address - Country:US
Mailing Address - Phone:336-677-1800
Mailing Address - Fax:336-677-1802
Practice Address - Street 1:102 WOODLYN DR
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-6673
Practice Address - Country:US
Practice Address - Phone:336-677-1800
Practice Address - Fax:336-677-1802
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2016-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP6184225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7213025Medicaid