Search › Georgia › 225200000X
Kevin Wildes, LPTA,CSCS
NPI 1912241357 · on the registry since 2012 · sole proprietor
Practice
- Address
- 133 Rosebury Dr
Canton, GA 30115 - Phone
- (770) 704-6307
Registry record
- Primary taxonomy
- 225200000X
225200000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-11-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia