Organization
ATHLETICO EXCEL NEBRASKA, LLC
Active
Other names
Excel Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization
Contact information
Practice address
1303 S 204TH ST, ELKHORN, NE 68022-2880
(402) 933-9111
(402) 933-9188
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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