Individual
CANDACE M WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4747 MIDDLE SETTLEMENT RD, NEW HARTFORD, NY 13413-4983
(315) 793-8580
(315) 223-4718
Mailing address
1 WESTBROOK DR, WHITESBORO, NY 13492-1631
(315) 525-2877
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
024327-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02554763
—
NY
01
—
11516408
CAQH
NY
Enumeration date
01/10/2007
Last updated
09/13/2012
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