Provider Demographics
NPI:1952324626
Name:RAWLINGS, MICHAEL D (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:D
Last Name:RAWLINGS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2404 S. LOCUST STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-0000
Mailing Address - Country:US
Mailing Address - Phone:575-521-4296
Mailing Address - Fax:575-521-4494
Practice Address - Street 1:2404 S. LOCUST ST.
Practice Address - Street 2:SUITE 5
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-0000
Practice Address - Country:US
Practice Address - Phone:575-521-4296
Practice Address - Fax:575-521-4494
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5587-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40442200Medicaid