Individual
KENNETH WESSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 MARKET PLACE BLVD, CARTERSVILLE, GA 30121-2236
(470) 210-1164
Mailing address
PO BOX 208707, DALLAS, TX 75320-0949
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012115
GA
Other
Enumeration date
09/16/2015
Last updated
04/20/2021
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