Provider Demographics
NPI:1730302803
Name:FUCHS, COURTNEY A (OTR)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:A
Last Name:FUCHS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 LAKE AVENUE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563
Mailing Address - Country:US
Mailing Address - Phone:574-935-2211
Mailing Address - Fax:574-935-2341
Practice Address - Street 1:1915 LAKE AVENUE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563
Practice Address - Country:US
Practice Address - Phone:574-935-2211
Practice Address - Fax:574-935-2341
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003269A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist