| Doctor Name: | MRS. IRMA TETRUASHVILY |
| NPI Number: | 1073629077 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT,GCS,SCS |
| License Number: | 40QA00988600 |
| Business Practice Address: | 9 Normandy Rd Marlton, NJ - 080535525 |
| Business Phone Number: | 8565520449 |
| Business Fax Number: | 8565520187 |
| Mailing Address: | 9 Normandy Rd, MARLTON |
| State: | NJ |
| Postal Code: | 080535525 |
| Phone Number: | 8565520449 |
| Fax Number: | 8565520187 |
| NPI Enumeration Date: | 08/22/2006 |
| NPI Last Update Date: | 01/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 40QA00988600 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |