Individual
JACK WYNN ROLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
324 NORTH 1680 EAST, ST GEORGE, UT 84790
(435) 674-1269
(435) 674-1269
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171
(801) 942-2729
(801) 942-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1140732401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D4211
—
UT
Enumeration date
09/02/2006
Last updated
07/08/2007
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