Organization
ATHLETICO LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization
Contact information
Practice address
10560 HARTLAND SQUARE DR, UNIT 4, HARTLAND, MI 48353-2624
(810) 279-2899
(810) 279-1114
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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