Individual
MICHAEL IMMELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRS HS
Contact information
Practice address
2065 STONERIDGE DR, CIRCLEVILLE, OH 43113-8956
(740) 500-1391
(740) 500-1391
Mailing address
2065 STONERIDGE DR, CIRCLEVILLE, OH 43113-8956
(740) 500-1391
(740) 500-1391
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.005987
OH
Other
Enumeration date
08/19/2025
Last updated
08/19/2025
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