# EASTERN IOWA THERAPEUTICS P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Athletico Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689137085
- **Authorized official:** JUANA GRANADOS (CREDENTIALING MANAGER)
- **Authorized official phone:** (630) 575-1980

## Contact information

- **Practice address:** 440 E CHERRY ST, VERMILLION, SD 57069-1403
- **Practice address phone:** (605) 741-0003
- **Practice address fax:** (605) 202-6414
- **Mailing address:** 600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
- **Mailing address phone:** (630) 575-6250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2019
- **Last updated:** 04/11/2019