Organization
PROREHAB, PC
Active
Other names
ATHLETICO PHYSICAL THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA L GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization
Contact information
Practice address
3726 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63109-1800
(314) 351-7172
(314) 351-6885
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
(630) 928-5080
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/18/2006
Last updated
01/17/2020
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