Healthcare Provider Details

I. General information

NPI: 1760675987
Provider Name (Legal Business Name): NAN REINHARDT, OTR/L & ASSOC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W WARREN STREET
ROBERTS WI
54023
US

IV. Provider business mailing address

PO BOX 220
ROBERTS WI
54023
US

V. Phone/Fax

Practice location:
  • Phone: 715-749-3890
  • Fax: 715-749-4081
Mailing address:
  • Phone: 715-749-3890
  • Fax: 715-749-4081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: NANCY A REINHARDT
Title or Position: DIRECTOR, OCCUPATIONAL THERAPIST
Credential: OTR
Phone: 715-749-3890