Provider Demographics
NPI:1962670851
Name:RAWLS, RONI A (PT, DPT, OCS)
Entity Type:Individual
Prefix:MRS
First Name:RONI
Middle Name:A
Last Name:RAWLS
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301B DAYTON PIKE
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-4202
Mailing Address - Country:US
Mailing Address - Phone:423-843-1014
Mailing Address - Fax:423-843-1016
Practice Address - Street 1:8301B DAYTON PIKE
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-4202
Practice Address - Country:US
Practice Address - Phone:423-843-1014
Practice Address - Fax:423-843-1016
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist