Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kendall E Wilde, DPT

Individual provider Physical Therapist · NPI 1417405499

Kendall E Wilde, DPT is a Physical Therapist in Kennesaw, Georgia. Licensed in Arizona and Georgia. Registered with an NPI since 2016.

Licensed in
AZ, GA
In the registry since
2016
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1615 Ridenour Blvd NW Ste 204
Kennesaw, GA 30152-4464
Phone: (770) 580-8070
Fax: (770) 285-8751
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT013169 (GA)
Physical Therapist Taxonomy 225100000X · Licence 12414 (AZ)

Record details

NPI number1417405499
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 19, 2016
Last updated in NPPESOctober 20, 2017
Mailing address8541 E Anderson Dr Ste 100, Ste 100, Scottsdale, AZ 85255-5430

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