Provider Demographics
NPI:1841540580
Name:RAWLINGS LOGAN, JAMILA C (PT)
Entity type:Individual
Prefix:
First Name:JAMILA
Middle Name:C
Last Name:RAWLINGS LOGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 KETTERING DR STE A1
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1676
Mailing Address - Country:US
Mailing Address - Phone:240-312-2010
Mailing Address - Fax:240-312-2011
Practice Address - Street 1:77 KETTERING DR STE A1
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1676
Practice Address - Country:US
Practice Address - Phone:240-312-2010
Practice Address - Fax:240-312-2011
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist