Provider Demographics
NPI:1073356291
Name:ROLFE, CAMPBELL LYNNE (DPT)
Entity type:Individual
Prefix:MS
First Name:CAMPBELL
Middle Name:LYNNE
Last Name:ROLFE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:CAMPBELL
Other - Middle Name:LYNNE
Other - Last Name:ROLFE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:215 AVON RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-2525
Mailing Address - Country:US
Mailing Address - Phone:615-972-1698
Mailing Address - Fax:
Practice Address - Street 1:256 GERMANTOWN BEND CV STE 102A
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-5212
Practice Address - Country:US
Practice Address - Phone:901-522-6671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-15
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist