Individual
DR. DIANA IMMENHAUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
255 E OLD STURBRIDGE RD, BRIMFIELD, MA 01010-9647
(413) 245-3389
Mailing address
PO BOX 40, SOUTHBRIDGE, MA 01550-0040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
283013
NY
207Q00000X
Family Medicine Physician
Primary
295025
MA
Other
Enumeration date
03/31/2013
Last updated
02/02/2023
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