Individual
DANIEL MARK IMMEKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6737 SUDBURY, CORPUS CHRISTI, TX 78414-2409
(361) 779-4112
Mailing address
6737 SUDBURY, CORPUS CHRISTI, TX 78414-2409
(361) 779-4112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1155468
TX
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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