Individual
IRINA TYUTYUNNIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
862 HENDRIX ST., PHILA, PA 19116-2526
(215) 713-6262
Mailing address
862 HENDRIX ST., PHILA, PA 19116-2526
(215) 713-6262
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/29/2011
Last updated
12/07/2011
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