Provider Demographics
NPI:1639281421
Name:RAWLINGS, LANCE SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:SCOTT
Last Name:RAWLINGS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 E 9400 S
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3671
Mailing Address - Country:US
Mailing Address - Phone:801-569-8181
Mailing Address - Fax:801-569-8191
Practice Address - Street 1:891 E 9400 S
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3671
Practice Address - Country:US
Practice Address - Phone:801-569-8181
Practice Address - Fax:801-569-8191
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2787791202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTT04787Medicare UPIN