Healthcare Provider Details

I. General information

NPI: 1780218560
Provider Name (Legal Business Name): MORGAN LEE REKLAITIS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 S 41ST ST
MANITOWOC WI
54220-7316
US

IV. Provider business mailing address

2300 WESTERN AVE
MANITOWOC WI
54220-3712
US

V. Phone/Fax

Practice location:
  • Phone: 920-320-3100
  • Fax: 920-320-5114
Mailing address:
  • Phone: 920-320-3100
  • Fax: 920-320-5114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6701-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: