Provider Demographics
NPI:1811230253
Name:IYER, RAJESHWARI N (MPT)
Entity Type:Individual
Prefix:MRS
First Name:RAJESHWARI
Middle Name:N
Last Name:IYER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 PARK PLACE LN APT 39
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-5267
Mailing Address - Country:US
Mailing Address - Phone:909-362-2994
Mailing Address - Fax:
Practice Address - Street 1:2738 PARK PLACE LN APT 39
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-5267
Practice Address - Country:US
Practice Address - Phone:909-362-2994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11925-242251G0304X
IL070.0187082251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics