Individual
KYLE E FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4743 ATLANTA HWY STE 100, LOGANVILLE, GA 30052-2686
(770) 466-9343
(770) 466-9345
Mailing address
2400 WISTERIA DR, SUITE A, SNELLVILLE, GA 30078-2689
(770) 982-0102
(770) 982-0130
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011092
GA
Other
Enumeration date
08/02/2013
Last updated
10/07/2021
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