Organization
ATHLETICO LTD
Active
Other names
ATHLETICO PHYSICAL THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING DIRECTOR)
(630) 575-1980
Entity
Organization
Contact information
Practice address
229 S STEWART RD STE E-3, LIBERTY, MO 64068-4206
(816) 656-3695
(816) 656-3696
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
07/14/2017
Last updated
07/01/2026
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