Provider Demographics
NPI:1588710362
Name:RAWLINGS, ROBERT BAILEY IV (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BAILEY
Last Name:RAWLINGS
Suffix:IV
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6684 BEAN MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3568
Mailing Address - Country:US
Mailing Address - Phone:615-521-4820
Mailing Address - Fax:
Practice Address - Street 1:420 E 120TH AVE
Practice Address - Street 2:SUITE B-8
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-1127
Practice Address - Country:US
Practice Address - Phone:303-280-3838
Practice Address - Fax:303-280-3837
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7759225100000X
COPTL.0014383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist