Provider Demographics
NPI:1487934741
Name:PRCHAL, CORTNEY LEE (OTR/L CHT)
Entity type:Individual
Prefix:MRS
First Name:CORTNEY
Middle Name:LEE
Last Name:PRCHAL
Suffix:
Gender:F
Credentials:OTR/L CHT
Other - Prefix:MISS
Other - First Name:CORTNEY
Other - Middle Name:LEE
Other - Last Name:BOHNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13825 52ND AVE N APT 1007
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-1639
Mailing Address - Country:US
Mailing Address - Phone:651-208-3644
Mailing Address - Fax:
Practice Address - Street 1:2805 CAMPUS DR STE 465
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2680
Practice Address - Country:US
Practice Address - Phone:612-863-6029
Practice Address - Fax:612-863-8942
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104061225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand