Individual
CORY FURY BRAINARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
15465 OAK LANE SUITE 100 C, GULFPORT, MS 39503-2663
(504) 615-2493
(228) 265-8323
Mailing address
15465 OAK LANE SUITE 100 C, GULFPORT, MS 39503-2663
(504) 615-2493
(228) 265-8323
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1903
MS
225X00000X
Occupational Therapist
Z10511
LA
Other
Enumeration date
03/28/2007
Last updated
06/13/2022
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