Provider Demographics
NPI:1912588633
Name:HANYCH, JEANNIE (PT)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:
Last Name:HANYCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:MARIE
Other - Last Name:HANYCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:621 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1341
Mailing Address - Country:US
Mailing Address - Phone:610-506-9465
Mailing Address - Fax:
Practice Address - Street 1:1615 E BOOT RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-6001
Practice Address - Country:US
Practice Address - Phone:484-653-4426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008066L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist