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
5708 75TH ST UNIT B, KENOSHA, WI 53142-3635
(262) 697-9135
(262) 697-9175
Mailing address
5708 75TH ST, KENOSHA, WI 53142-3635
(262) 697-9135
(262) 697-9175
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Enumeration date
09/17/2012
Last updated
10/27/2021
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