Healthcare Provider Details

I. General information

NPI: 1942128129
Provider Name (Legal Business Name): TAMMY REIGLES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 LOWELL ST
TWO RIVERS WI
54241-3412
US

IV. Provider business mailing address

3120 FAIRWAY DR
CATO WI
54230-8596
US

V. Phone/Fax

Practice location:
  • Phone: 920-793-7522
  • Fax:
Mailing address:
  • Phone: 920-323-7315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2940-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: