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Organization

ATHLETICO LTD

Active
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Organization

ATHLETICO LTD

Active
Other names
Athletico Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization

Contact information

Practice address
815 S MINNESOTA AVE, SIOUX FALLS, SD 57104-4828
(605) 231-5586
(605) 231-5587
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
(630) 928-5080

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
NULL

Other

Enumeration date
11/01/2016
Last updated
05/14/2019
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