Individual
MR. EDWARD GABRIEL IMMEKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3500
(608) 825-3598
Mailing address
1808 W BELTLINE HWY, MADISON, WI 53713-2334
(608) 250-1497
(608) 250-1384
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10962-024
WI
Other
Enumeration date
03/27/2008
Last updated
03/14/2021
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