Provider Demographics
NPI:1871903799
Name:DRURY, COURTNEY (OTR)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:DRURY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:DRURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:17424 109TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729
Mailing Address - Country:US
Mailing Address - Phone:715-781-9710
Mailing Address - Fax:
Practice Address - Street 1:910 BEAR PAW AVENUE
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868
Practice Address - Country:US
Practice Address - Phone:715-234-2604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5442-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist