Edward Gabriel Immekus, PT
Physical Therapist in Sun Prairie, WI. Individual provider (NPI-1).
NPI number1992977185
StatusActive
Last updated in NPPESMar 14, 2021
Details
- NPI
- 1992977185
- Entity type
- Individual (NPI-1)
- Name
- Mr. Edward Gabriel Immekus
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2008
- Certification date
- Mar 14, 2021
- Last updated
- Mar 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 10962-024 | WI | Yes |
Practice location
10 Tower DrSun Prairie, WI 53590-1239
Phone 608-825-3500 · Fax 608-825-3598
Mailing address
1808 W Beltline HwyMadison, WI 53713-2334
Phone 608-250-1497 · Fax 608-250-1384
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All 25 Physical Therapist providers in Sun Prairie · All 663 providers in Sun Prairie
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