Individual
MRS. IRMA TETRUASHVILY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT,GCS,SCS
Contact information
Practice address
9 NORMANDY RD, MARLTON, NJ 08053-5525
(856) 552-0449
(856) 552-0187
Mailing address
9 NORMANDY RD, MARLTON, NJ 08053-5525
(856) 552-0449
(856) 552-0187
Taxonomy
Speciality
Code
Description
License number
State
2251C2600X
Cardiopulmonary Physical Therapist
40QA00988600
NJ
2251G0304X
Geriatric Physical Therapist
Primary
40QA00988600
NJ
2251X0800X
Orthopedic Physical Therapist
40QA00988600
NJ
Other
Enumeration date
08/22/2006
Last updated
01/24/2011
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