Individual
KENNA W WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1009 N MONROE ST, ALBANY, GA 31701-1903
(229) 883-0298
(229) 438-7898
Mailing address
2402 DEVON DR, ALBANY, GA 31721-2126
(229) 420-0227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003077
GA
Other
Enumeration date
09/06/2005
Last updated
04/02/2009
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