Individual
CHAD WISSLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
176 WALKER ST, LOWELL, MA 01854-3126
(978) 452-9252
(978) 970-0271
Mailing address
27 BLUESTONE DR, NASHUA, NH 03060-6821
(617) 777-2215
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17268
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
479040
TUFTS PROVIDER ID
MA
01
—
Y68579
BLUE CROSS PROVIDER ID
MA
Enumeration date
10/04/2006
Last updated
12/10/2007
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