Provider Demographics
NPI:1962833236
Name:RAWLINS, NICHOLAS (ATC)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:RAWLINS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E WEBER DR
Mailing Address - Street 2:APT 1018
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-1775
Mailing Address - Country:US
Mailing Address - Phone:707-684-9406
Mailing Address - Fax:
Practice Address - Street 1:615 E WEBER DR
Practice Address - Street 2:APT 1018
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-1775
Practice Address - Country:US
Practice Address - Phone:707-684-9406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ22Other(RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS