Individual
MR. CARL J. WIGHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
679 S MAIN ST, HAVERHILL, MA 01835-8721
(978) 372-3211
Mailing address
790 DALE ST, NORTH ANDOVER, MA 01845-1420
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16417
MA
225100000X
Physical Therapist
QA08473
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030044
NEIGHBORHOOD HEALTH PLAN
MA
05
—
0326950
—
MA
01
—
34836379
AETNA
MA
01
—
AA19502
HARVARD PILGRIM
MA
01
—
NO NUMBER
TRICARE
MA
01
—
NONE
UNITED HEALTHCARE
MA
01
—
Y68196
BCBS
MA
Enumeration date
06/28/2005
Last updated
02/12/2014
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