Provider Demographics
NPI:1366582553
Name:HAAG, CAROL WIGGLE (PT)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:WIGGLE
Last Name:HAAG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:30377 TWIN OAKS RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36421-8916
Mailing Address - Country:US
Mailing Address - Phone:334-388-3224
Mailing Address - Fax:334-388-3224
Practice Address - Street 1:245 CAHABA VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2216
Practice Address - Country:US
Practice Address - Phone:205-942-6820
Practice Address - Fax:205-942-5627
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist