Individual
LINDA IMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
831 PINE BEACH RD, MARINETTE, WI 54143-4225
(715) 732-5796
Mailing address
281 ROSELAWN BLVD, GREEN BAY, WI 54301-1303
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1335-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40013500
—
WI
Enumeration date
09/17/2006
Last updated
07/08/2007
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