Individual
MR. CARL J. WIGHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
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
Update your record
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