Provider Demographics
NPI:1295015592
Name:RAWLINGS, JONATHAN BLAKE (PT, DPT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:BLAKE
Last Name:RAWLINGS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:1260 MARS HILL RD STE 115
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4943
Practice Address - Country:US
Practice Address - Phone:706-705-6110
Practice Address - Fax:706-705-6111
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT26257225100000X
GAPT011389225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist