KEVIN F WILDES

CANTON, GA
NPI1912241357
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: GA  1633)
Enumeration Date2012-11-26
Last Update Date2012-11-26
Business Address
-- KEVIN F WILDES LPTA,CSCS
133 ROSEBURY DR
CANTON, GA 30115-7558
Phone number: 770-704-6307
Mailing Address
-- KEVIN F WILDES LPTA,CSCS
133 ROSEBURY DR
CANTON, GA 30115-7558
Phone number: 770-704-6307
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